We read with interest the findings of Peng et al. recently published in the Annals of Surgery.1 Adoption of minimally invasive approaches to pancreaticoduodenectomy (PD) among the HPB community has been slow globally owing to its technical complexity. The utilisation of a robotic platform has the potential to address the technical difficulties encountered with laparoscopic PD; providing 3D vision with increased depth perception, increased range of motion due to wristed instruments, standardisation of surgery through the same instruments, and elimination of both instrument and camera tremor and variability. Indeed, the learning curve for basic surgical skills is significantly less with a robotic compared to the laparoscopic platform.2 In reviewing their database of 450 robotic-assisted PD the authors identify 250 cases as the point at which the learning curve is obtained. Interestingly, this coincided with the establishment of a standardised 10 step approach to all robotic PD at their centre.

 

LINK