Diaz Adrian, Hays Sarah, Hogg Melissa E
Department of Surgery, University of Chicago, Chicago, IL, USA.
Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA.
Ann Surg Oncol. 2025 Aug;32(8):5423-5425. doi: 10.1245/s10434-025-17595-0. Epub 2025 Jun 2.
Minimally invasive pancreatic resection (MIPR) has emerged as a safe and effective approach for select patients with pancreatic ductal adenocarcinoma (PDAC), particularly for distal pancreatectomy. Ongoing randomized trials such as DIPLOMA 2 × 2 and PORTAL will further clarify its role in pancreatoduodenectomy, especially with robotic assistance. However, widespread adoption depends not only on evidence but also on access to technology and structured training programs. Expanding dedicated training, simulation-based education, and institutional support will be essential to ensure safe implementation. At the same time, emerging technologies such as augmented reality and next-generation robotics may help lower technical thresholds, lower prices, and accelerate adoption. The continued convergence of high-quality evidence, advanced surgical tools, and equitable implementation strategies will be critical to making MIPR a broadly accessible standard for PDAC, improving outcomes without compromising oncologic rigor. Barriers will need to be overcome to continue growth, such as limited availability of robotic platforms, high costs, and disparities in care.
微创胰腺切除术（MIPR）已成为治疗特定胰腺导管腺癌（PDAC）患者的一种安全有效的方法，特别是对于远端胰腺切除术。正在进行的随机试验，如DIPLOMA 2×2和PORTAL试验，将进一步阐明其在胰十二指肠切除术中的作用，尤其是在机器人辅助下。然而，广泛应用不仅取决于证据，还取决于技术的可及性和结构化培训项目。扩大专门培训、基于模拟的教育以及机构支持对于确保安全实施至关重要。与此同时，诸如增强现实和下一代机器人技术等新兴技术可能有助于降低技术门槛、降低价格并加速应用。高质量证据、先进手术工具和公平实施策略的持续融合对于使MIPR成为PDAC广泛可及的标准、在不影响肿瘤学严谨性的情况下改善治疗效果至关重要。需要克服一些障碍以实现持续增长，例如机器人平台可用性有限、成本高昂以及护理差异等。
