Anesthesia

Minimally invasive surgery (MIS) has achieved worldwide acceptance in various fields, however, pancreatic surgery remains one of the most challenging abdominal procedures. Laparoscopic pancreatic surgery has not gained broad acceptance due to the complexity of the procedure, the accuracy required to perform the operation, and the steep learning curve involved. Indeed, the procedure has only achieved widespread consensus for distal pancreatectomy. In the field of major pan-creaticoduodenectomies, the laparoscopic approach is still considered to be an ex-tremely demanding method due to the challenge of reconstruction. The develop-ment of the robotic platform has overcome many of the disadvantages of traditional laparoscopy. Robotic surgery (RS) gives the surgeon a three-dimensional stereo-scopic view of the operating field and restores hand-eye coordination that is often lost in traditional laparoscopy when the camera is offset to the plane of dissection. Given the limitations of current laparo-scopic technology and the need for meticu-lous vascular control as well as complex reconstruction in pancreatic surgery, we hypothesized that RS would be particular-ly a good option for these procedures. We now report our experience with 50 consec-utive robotic-assisted pancreatic resections. We evaluate the safety, feasibility and versatility of this platform in the hands of dedicated, high volume hepato-pancreato-biliary (HPB) surgeons.