International survey on opinions and use of robot-assisted and laparoscopic minimally invasive pancreatic surgery: 5-year follow up

HPB (Oxford). 2024 Jan;26(1):63-72. doi: 10.1016/j.hpb.2023.09.004. Epub 2023 Sep 6.

Abstract

Background: Evidence on the value of minimally invasive pancreatic surgery (MIPS) has been increasing but it is unclear how this has influenced the view of pancreatic surgeons on MIPS.

Methods: An anonymous survey was sent to members of eight international Hepato-Pancreato-Biliary Associations. Outcomes were compared with the 2016 international survey.

Results: Overall, 315 surgeons from 47 countries participated. The median volume of pancreatic resections per center was 70 (IQR 40-120). Most surgeons considered minimally invasive distal pancreatectomy (MIDP) superior to open (ODP) (94.6%) and open pancreatoduodenectomy (OPD) superior to minimally invasive (MIPD) (67.9%). Since 2016, there has been an increase in the number of surgeons performing both MIDP (79%-85.7%, p = 0.024) and MIPD (29%-45.7%, p < 0.001), and an increase in the use of the robot-assisted approach for both MIDP (16%-45.6%, p < 0.001) and MIPD (23%-47.9%, p < 0.001). The use of laparoscopy remained stable for MIDP (91% vs. 88.1%, p = 0.245) and decreased for MIPD (51%-36.8%, p = 0.024).

Conclusion: This survey showed considerable changes of MIPS since 2016 with most surgeons considering MIDP superior to ODP and an increased use of robot-assisted MIPS. Surgeons prefer OPD and therefore the value of MIPD remains to be determined in randomized trials.

MeSH terms

  • Follow-Up Studies
  • Humans
  • Laparoscopy* / adverse effects
  • Minimally Invasive Surgical Procedures
  • Pancreatectomy / adverse effects
  • Pancreatic Neoplasms* / surgery
  • Pancreaticoduodenectomy / adverse effects
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Robotic Surgical Procedures* / adverse effects
  • Robotics*
  • Treatment Outcome