Robotic-Assisted Pancreaticoduodenectomy (Whipple)
摘要
In the last decade, there has been a surge in global interest in robotic hepatobiliary surgery, particularly the robotic Whipple procedure, now available in major US medical centers. Minimally invasive surgery has demonstrated advantages over open procedures, extending to cases of pancreatic cancer, where robotic surgery holds the potential for quicker recovery and potentially enhanced survival rates. Although laparoscopic Whipple procedures offer benefits, their limited adoption is attributed to challenges in the reconstruction process. Robotic Whipple procedures present a solution, featuring a stable platform, three-dimensional visualization, and articulated instruments that address challenges and improve surgeon comfort. Establishing a robotic Whipple program involves a systematic approach and careful patient selection, beginning with early-stage, resectable cases. Surgeons must possess proficiency in open Whipple techniques and prior experience in robotic surgery. The procedure encompasses meticulous steps, from pancreatic neck dissection to reconstruction, as well as diligent postoperative care with an enhanced recovery after surgery (ERAS) protocol. While evidence supporting robotic Whipple is drawn from early experiences, studies indicate comparable or superior outcomes to open surgery, suggesting its growing acceptance as an alternative in hepatobiliary surgery.