Overall Evaluation of the Safety and Feasibility of Robotic Middle Pancreatectomy

Middle pancreatectomy is an alternative surgical procedure for lesions of the neck or body of the pancreas. With more pancreatic parenchyma reserved, it can reduce the risk of postoperative endocrine and exocrine insufficiency, compared with distal pancreatectomy. Middle pancreatectomy in the minimally invasive (MI) approach has been confirmed to be feasible in several studies. Patients can benefit from minimally invasive middle pancreatectomy (MIMP) for smaller operative wounds and enhanced recovery with the same oncologic outcome and overall survival. Robotic surgery, a novel MI technique, has applied in the pancreatic surgery since 2003. But it remains controversial whether robotic middle pancreatectomy (RMP) can acquire the same therapeutic effect like conventional laparoscopic surgery for lack of evidence. This chapter reviewed the history of middle pancreatectomy (MP), the application of minimally invasive techniques in MP, the advantages of robotic pancreatic surgery, and shared our experience of performing MP in the robotic approach to evaluate the safety and feasibility of RMP.