Wong Paul, Lewis Aaron, Thornblade Lucas W, Maker Ajay V, Fong Yuman, Melstrom Laleh G
Division of Surgical Oncology, Department of Surgery, University of California, San Francisco, United States; Division of Surgical Oncology, Department of Surgery, City of Hope Medical Center, United States.
Division of Surgical Oncology, Department of Surgery, City of Hope Medical Center, United States.
HPB (Oxford). 2025 Sep;27(9):1223-1235. doi: 10.1016/j.hpb.2025.06.009. Epub 2025 Jun 23.
Robotic surgery has been developed as an additional minimally invasive approach to pancreatectomy. We assessed case selection and perioperative outcomes in patients undergoing robotic pancreatectomy for pancreatic adenocarcinoma over time.
The National Cancer Database (2010-2019) was queried to identify all pancreatic adenocarcinoma patients that underwent robotic pancreatoduodenectomy (RPD) or distal pancreatectomy (RDP). Two periods were established: Early cohort (2010-2014) and Modern cohort (2015-2019).
Of 2245 patients who underwent RPD or RDP, 78.4 % of RPD and 77.6 % of RDP were in the Modern cohort. Robotic approach increased from 2010 to 2019 (RPD: 1.1 %-7.5 %, RDP: 2.2 %-19.4 %; both p < 0.001). Compared to Early, Modern RPD patients were more likely to have non-private insurance (68.5 % vs. 58.7 %), and both RPD (47.0 % vs. 23.4 %) and RDP (47.3 % vs. 32.1 %) patients were more frequently treated in non-academic hospitals (all p < 0.01). Shorter LOS was noted in the Modern RPD (6 vs. 8 days) and RDP cohorts (5 vs. 6 days, both p < 0.001), without differences in readmission/mortality. In RPD and RDP, no differences in overall survival were observed between the eras.
Robotic pancreatectomy for pancreatic adenocarcinoma has increased over time with greater inclusion of patients and hospital types while outcomes have remained similar.
