Lee Boram, Han Ho-Seong, Yoon Yoo-Seok, Lee Jun Suh
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si 13605, Gyeonggi-do, Republic of Korea.
J Clin Med. 2025 Jun 4;14(11):3960. doi: 10.3390/jcm14113960.
Reduced-port totally robotic pancreaticoduodenectomy (rpRPD) has been introduced to address limitations of conventional robotic pancreaticoduodenectomy (cRPD), particularly regarding assistant mobility and visualization. This study aimed to evaluate the clinical feasibility and procedural consistency of rpRPD in comparison with cRPD and laparoscopic pancreaticoduodenectomy (LPD). : We conducted a retrospective cohort study of patients who underwent pancreaticoduodenectomy between January 2015 and December 2024. Patients were categorized into rpRPD (n = 40), cRPD (n = 60), and LPD (n = 262) groups. Clinical outcomes and learning curves were compared using regression and cumulative sum (CUSUM) analysis. : Baseline characteristics were similar across groups. The rpRPD group demonstrated significantly shorter operative time ( < 0.001) and lower blood loss ( < 0.05) than cRPD, with no significant differences in postoperative complications or hospital stay. The learning curve analysis revealed that rpRPD had lower variance (5839.3 vs. 8919.1) and more stable performance than cRPD despite a slightly longer stabilization point. Lymph node retrieval was comparable across groups, supporting oncological equivalence. : rpRPD offers comparable perioperative and oncologic outcomes to cRPD and LPD while improving operative efficiency and procedural predictability. It represents a technically feasible and safe option for minimally invasive pancreatic surgery.
为解决传统机器人胰十二指肠切除术（cRPD）的局限性，尤其是在助手移动性和可视化方面的局限，减少端口全机器人胰十二指肠切除术（rpRPD）应运而生。本研究旨在评估rpRPD与cRPD及腹腔镜胰十二指肠切除术（LPD）相比的临床可行性和手术操作的一致性。我们对2015年1月至2024年12月期间接受胰十二指肠切除术的患者进行了一项回顾性队列研究。患者被分为rpRPD组（n = 40）、cRPD组（n = 60）和LPD组（n = 262）。使用回归分析和累积和（CUSUM）分析比较临床结果和学习曲线。各组的基线特征相似。rpRPD组的手术时间明显短于cRPD组（<0.001），失血量也低于cRPD组（<0.05），术后并发症或住院时间无显著差异。学习曲线分析显示，尽管rpRPD的稳定点稍长，但与cRPD相比，其方差更低（5839.3对8919.1），性能更稳定。各组的淋巴结清扫情况相当，支持肿瘤学等效性。rpRPD在围手术期和肿瘤学结果方面与cRPD和LPD相当，同时提高了手术效率和手术操作的可预测性。它是微创胰腺手术中一种技术上可行且安全的选择。
