Initiation of a robotic pancreatoduodenectomy program using virtual collaboration Journal Article
| Authors: | Blair, A. B.; Soares, K. C.; Guerrero, C.; Drebin, J.; Jarnagin, W. R.; He, J.; Wei, A. C. |
| Article Title: | Initiation of a robotic pancreatoduodenectomy program using virtual collaboration |
| Abstract: | Background: Adoption of robotic pancreatoduodenectomy (RPD) is growing, although there are challenges for safe introduction of this technique, including limitations in on-site expert proctoring. We developed and implemented a structured approach for safe introduction of a new RPD program using virtual collaboration. Methods: A structured framework for introducing a RPD program was designed; key steps included obtaining additional training, identifying required resources, establishing a dedicated team, and patient safety considerations. Virtual collaboration with a proctor for bidirectional communication was utilized for remote operative guidance. In the initial cohort, perioperative data and postoperative outcomes were extracted from a prospectively maintained database. Results: From August 2020 to December 2023, 68 patients underwent RPD. The median operative time was 407 min with an estimated blood loss of 150 mL. Median length of stay was 8 days. Negative margins were obtained in 90% of resections. Operative time was significantly shorter in the second half of cases compared to the first (380min vs 441min, p < 0.01) and rate of conversion decreased (6% vs 21%). Conclusion: The safe initiation of a structured RPD program is feasible through virtual expert collaboration. With careful consideration and an appropriate environment, excellent perioperative outcomes are achievable even for initial cases. © 2024 |
| Keywords: | adult; controlled study; aged; major clinical study; lymph node dissection; pancreaticoduodenectomy; gastrointestinal stromal tumor; intraductal papillary mucinous tumor; training; operation duration; surgical training; blood transfusion; pancreas adenocarcinoma; pancreatectomy; gastrectomy; minimally invasive surgery; bile duct carcinoma; endoscopy; distal pancreatectomy; mucinous cystadenoma; cardiopulmonary bypass; pancreas fistula; pancreaticojejunostomy; virtual reality; laparoscopic cholecystectomy; endotracheal intubation; human; male; female; article; robotic pancreatoduodenectomy |
| Journal Title: | HPB |
| Volume: | 26 |
| Issue: | 12 |
| ISSN: | 1365-182X |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2024-12-01 |
| Start Page: | 1528 |
| End Page: | 1535 |
| Language: | English |
| DOI: | 10.1016/j.hpb.2024.09.001 |
| PUBMED: | 39289133 |
| PROVIDER: | scopus |
| PMCID: | PMC12132092 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in PDF. Corresponding MSK author is Alice C. Wei -- Source: Scopus |
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