Choi Yoo Jin, Jeon Su Min, Yu Sehyeon, Jo Hye-Sung, Kim Dong-Sik, Yu Young-Dong
Department of Surgery, Division of HBP Surgery & Liver Transplantation, Korea University College of Medicine, 73 Goryeodae-Ro Seongbuk-Gu, Seoul, 02841, Korea.
Surg Endosc. 2025 Jun;39(6):4017-4025. doi: 10.1007/s00464-025-11695-4. Epub 2025 Apr 22.
In the era of robotic surgery, pancreatoduodenectomy (PD) has been performed with the Xi system. Recently, the advent of the SP system has allowed more minimally invasive surgery with reduced ports. We have applied the SP system to perform PD. We aimed to report our initial experience of robotic-assisted PD using the da Vinci single-port (SP) system to demonstrate the safety and feasibility of this platform.
We retrospectively reviewed patients who underwent robotic-assisted pylorus-preserving pancreaticoduodenectomy (PPPD) between 2021 and 2023 at a single center. Robotic PPPD was performed using the da Vinci SP system with either four or two additional ports, utilizing a laparoscopic hybrid technique.
Of the 14 patients, six underwent the SP + 4 ports approach, and eight underwent the SP + 2 ports approach. The mean patient age was 60.2 years, and the mean body mass index was 22.5 ± 2.3 kg/m. The mean operative time was 444.29 ± 59.6 min, with an estimated intraoperative blood loss of < 500 ml in all cases. There were two cases of postoperative pancreatic fistula and one case of bile leak.
Robot-assisted PPPD using the da Vinci SP system is safe and feasible, with acceptable perioperative outcomes. We also report a successful SP + 2 port PPPD. Owing to the unique structure of the da Vinci SP system, our method has the potential to reduce the number of trocar sites and provide a gateway for better, minimally invasive surgeries. However, further reports assessing the experience are essential to establish its wide clinical practice.
在机器人手术时代，胰十二指肠切除术（PD）已通过Xi系统进行。最近，SP系统的出现使得手术切口减少，实现了更微创的手术。我们已应用SP系统进行PD手术。我们旨在报告使用达芬奇单孔（SP）系统进行机器人辅助PD手术的初步经验，以证明该平台的安全性和可行性。
我们回顾性分析了2021年至2023年在单一中心接受机器人辅助保留幽门胰十二指肠切除术（PPPD）的患者。机器人PPPD手术使用达芬奇SP系统，通过四孔或两孔附加技术，采用腹腔镜混合技术进行。
14例患者中，6例采用SP + 4孔入路，8例采用SP + 2孔入路。患者平均年龄为60.2岁，平均体重指数为22.5±2.3kg/m²。平均手术时间为444.29±59.6分钟，所有病例估计术中出血量均<500ml。术后发生2例胰瘘和1例胆漏。
使用达芬奇SP系统进行机器人辅助PPPD手术是安全可行的，围手术期结果可接受。我们还报告了一例成功的SP + 2孔PPPD手术。由于达芬奇SP系统的独特结构，我们的方法有可能减少套管针穿刺部位的数量，并为更好的微创手术提供途径。然而，需要更多的报告来评估经验，以确立其广泛的临床应用。
