Department of General Surgery, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Scand J Surg. 2020 Mar;109(1):29-33. doi: 10.1177/1457496920911815.
There has been a rapid development in minimally invasive pancreas surgery in recent years. The most recent innovation is robotic pancreatoduodenectomy. Several studies have suggested benefits as compared to the open or laparoscopic approach. This review provides an overview of studies concerning patient selection, volume criteria, and training programs for robotic pancreatoduodenectomy and identified knowledge gaps regarding barriers for safe implementation of robotic pancreatoduodenectomy.
A Pubmed search was conducted concerning patient selection, volume criteria, and training programs in robotic pancreatoduodenectomy.
A total of 20 studies were included. No contraindications were found in patient selection for robotic pancreatoduodenectomy. The consensus and the Miami guidelines advice is a minimum annual volume of 20 robotic pancreatoduodenectomy procedures per center, per year. One training program was identified which describes superior outcomes after the training program and shortening of the learning curve in robotic pancreatoduodenectomy.
Robotic pancreatoduodenectomy is safe and feasable for all indications when performed by specifically trained surgeons working in centers who can maintain a minimum volume of 20 robotic pancreatoduodenectomy procedures per year. Large proficiency-based training program for robotic pancreatoduodenectomy seem essential to facilitate a safe implementation and future research on robotic pancreatoduodenectomy.
近年来，微创胰腺手术发展迅速。最新的创新是机器人胰十二指肠切除术。几项研究表明，与开放或腹腔镜方法相比具有优势。这篇综述提供了关于机器人胰十二指肠切除术的患者选择、量度标准和培训计划的研究概述，并确定了有关安全实施机器人胰十二指肠切除术的障碍的知识空白。
对有关机器人胰十二指肠切除术的患者选择、量度标准和培训计划进行了 Pubmed 检索。
共纳入 20 项研究。在机器人胰十二指肠切除术的患者选择中未发现禁忌症。共识和迈阿密指南建议中心每年每例机器人胰十二指肠切除术的最低年手术量为 20 例。确定了一个培训计划，该计划描述了培训计划后的优异结果以及机器人胰十二指肠切除术学习曲线的缩短。
当由经过专门培训、在能够维持每年至少 20 例机器人胰十二指肠切除术手术量的中心工作的外科医生进行操作时，机器人胰十二指肠切除术对于所有适应证都是安全可行的。机器人胰十二指肠切除术的大型基于熟练程度的培训计划对于促进安全实施和未来的机器人胰十二指肠切除术研究至关重要。
