Robot-assisted techniques in pancreatic surgery—how we do it

Summary Robotic surgery is a promising development in minimally invasive pancreatic surgery due to its ability to improve dexterity and range of motion, facilitating the technically demanding anastomosis required during minimal-invasive pancreatic surgery. In experienced hands, robotic pancreaticoduodenectomy (PD) is equal to open pancreatic head resection in terms of short-term outcomes. Several studies have shown similar oncological outcomes, and there have been no differences in 30- and 90-day mortality rates. However, no guideline recommendations have been given for the use of robotic PD in cases of advanced pancreatic head cancer with vascular resection, or after neoadjuvant treatment, due to the lack of comparative data. In the hands of experts robotic PD is a feasible approach also for malignant diagnoses. Robot-assisted pancreatic surgery is a promising advancement in minimally invasive surgery, offering technical advantages but requiring a longer learning curve and higher costs. Further development and evaluation of the technique, elaborated training programs and proctoring are essential for a safe implementation of this technology.