Worldwide survey on opinions and use of minimally invasive pancreatic resection

Abstract

Background: The introduction of minimally invasive pancreatic resection (MIPR) into surgical practice has been slow and the worldwide utilization and attitudes towards MIPR remain unknown. Methods: We developed an anonymous online survey (61 questions) in order to gain knowledge on opinions and use of both, laparoscopic and robot-assisted pancreatic resections. The survey was sent to all surgeon members of the 6 largest hepato-pancreato-biliary associations. Results: In total, 435 surgeons from 50 countries completed the survey. Responders performed a median of 22(IQR:0-450) pancreatic resections as primary surgeon annually. Minimally invasive distal pancreatectomy (MIDP) was performed by 345(79%) surgeons with a total median experience of 20(IQR:10-50) MIDPs. Of surgeons performing MIDP, 338(98%) surgeons considered the overall value of MIDP superior or equivalent to the open approach. Minimally invasive pancreatoduodenectomy (MIPD) was performed by 124(29%) surgeons with a total median experience of 12(IQR:4-40) MIPDs. Of surgeons performing MIPD 96(77%) considered the overall value of MIPD superior or equivalent compared to open. The most important reason for not performing MIPR was a lack of specific training. Conclusion: This worldwide survey on MIPR shows that the current median annual number of MIPRs performed per surgeon remains low. Whereas most surgeons considered MIDP superior or equivalent to open distal pancreatectomy, this was not the case for MIPD. Defined training in MIPR appears necessary.