Robotic Pancreatectomy: What is the Current Evidence?

Laparoscopic pancreatectomy has evolved from resection of benign lesions to the treatment of malignant lesions without compromising patient safety and oncologic principles. Driven by the technical shortcomings of laparoscopic surgery, robotic pancreatectomy is the latest development in this evolution. Presently, there are limited but increasing amount of data comparing the outcomes of the various approaches for pancreatectomy: robotic versus laparoscopic and open pancreatectomy. Most studies to date are single large institutional retrospective case series or case-control studies reporting on the safety and feasibility of robotic pancreatectomies but most fail to address key issues like cost-benefit ratio and selection biases. Hence, presently, there is only low level evidence from retrospective studies supporting the use of robotic pancreatectomy. These studies have demonstrated that robotic pancreatectomy is safe and feasible with outcomes at least comparable to conventional laparoscopy and open surgery. There is some evidence suggesting that robotic surgery may decrease the learning curve and conversion rate in minimally invasive pancreatic surgery. Further research is needed to evaluate and compare the effectiveness of robotic pancreatectomy with conventional laparoscopy and open surgery.