Robotic Pylorus-Preserving Pancreaticoduodenectomy

The application and adoption of minimally invasive techniques in hepatopancreaticobiliary (HPB) surgery have been much slower when compared to other surgical disciplines such as urology, gynecology, colorectal, and bariatric surgery. Notably, HPB operations are uncommon, and they involve unusual complexity, with relatively high risk and “many moving parts.” The complexity of surgical steps undertaken during pancreaticoduodenectomy includes the precise dissection along major mesenteric vessels and reconstruction of biliary, pancreatic, and enteric anastomoses. There have been several variations of surgical techniques among centers that offer robotic pancreaticoduodenectomy. Our technique for pancreaticoduodenectomy is an outgrowth of our experience; herein, we describe our current technique for undertaking robotic pylorus-preserving pancreaticoduodenectomy.