Complete robotic assisted pancreatoduodenectomy

Argenis Herrera, MD, Kirpal Singh, MD, Dixon Brenner, MD. Saint Vincent Hospital

In this video we are presenting our technique for complete robotic-assisted pancreatico-duodenectomy (RAPD). We believe that the high definition 3D camera of the robotic system and unparalleled dexterity of the robotic arms improves patient safety and outcomes as opposed to the open or laparoscopic techniques. Specific steps in which these features are particularly helpful are the retroperitoneal dissection and the pancreatico-jejunostomy and choledocho-jejunostomy anastomoses. RAPD requires a robotic surgeon at the console and an advanced surgical assistant. Most studies of RAPD published thus far include highly selected patients, and to our knowledge there is no prospective randomized trial comparing robotic assisted to open or laparoscopic pancreaticoduodenectomy. Nonetheless, we are in support of the conclusions of many of these studies regarding the potential for the RAPD procedure to offer better oncologic, functional and economic outcomes versus the open or laparoscopic counterparts.

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