Article
Surgery
Sjors Klompmaker, Walderik J. van der Vliet, Stijn J. Thoolen, Ana Sofia Ore, Koen Verkoulen, Monica Solis-Velasco, Elena G. Canacari, Jonathan B. Kruskal, Khalid O. Khwaja, Jennifer F. Tseng, Mark P. Callery, Tara S. Kent, A. James Moser
Summary: This study successfully implemented robot-assisted distal pancreatectomy (RADP) by providing specific training to practicing surgeons, leading to improvements in perioperative blood loss, operating time, and length of stay without compromising safety. The results confirmed the efficacy and safety of RADP compared to open distal pancreatectomy (ODP) through propensity-score matching analysis.
Article
Oncology
Jeffrey Chen, Tess M. E. van Ramshorst, Sanne Lof, Bilal Al-Sarireh, Bergthor Bjornsson, Ugo Boggi, Fernando M. Burdio, Giovanni Butturini, Riccardo Casadei, Andrea Coratti, Mathieu D'Hondt, Safi Dokmak, Bjorn Edwin, Alessandro Esposito, Jean M. Fabre, Giovanni Ferrari, Fadhel S. Fteriche, Giuseppe K. Fusai, Bas Groot Koerkamp, Thilo Hackert, Asif Jah, Jin-Young Jang, Emanuele F. Kauffmann, Tobias Keck, Alberto Manzoni, Marco Marino, Quintus Molenaar, Elizabeth Pando, Patrick Pessaux, Andrea Pietrabissa, Zahir Soonawalla, Robert P. Sutcliffe, Lea Timmermann, Steven White, Vincent S. Yip, Alessandro Zerbi, Mohammad Abu Hilal, Marc G. Besselink
Summary: RDP and LDP provide comparable R0-resection rate and overall survival in experienced centers for patients with resectable pancreatic cancer. Although RDP appears to have favorable lymph node yield and conversion rate, LDP is associated with shorter operating time, less major complications, and shorter hospital stay. The specific benefits associated with each approach should be confirmed by multicenter, randomized trials.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Surgery
Matteo Palmeri, Niccolo Furbetta, Gregorio Di Franco, Desiree Gianardi, Simone Guadagni, Matteo Bianchini, Lorenzo Maria Fatucchi, Annalisa Comandatore, Andrea Moglia, Giulio Di Candio, Luca Morelli
Summary: In robot-assisted distal pancreatectomy, different strategies for pancreatic stump management have not shown significant advantages in reducing the occurrence of postoperative pancreatic fistula (POPF). The hand-sewn technique is more time-consuming, but remains essential in situations where staplers cannot be used.
INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY
(2023)
Article
Surgery
Haoda Chen, Ziyun Shen, Xiayang Ying, Yuanchi Weng, Yu Jiang, Hao Chen, Zhiwei Xu, Xiaxing Deng, Junjie Xie, Baiyong Shen
Summary: Visceral obesity is associated with higher CR-POPF rate and worse perioperative outcomes in pancreatic surgery, but for non-visceral obesity patients, RDP shows better outcomes compared to ODP.
INTERNATIONAL JOURNAL OF SURGERY
(2021)
Review
Surgery
Tess M. E. van Ramshorst, Eduard A. van Bodegraven, Pietro Zampedri, Meidai Kasai, Marc G. Besselink, Mohammad Abu Hilal
Summary: This systematic review and meta-analysis compared robot-assisted distal pancreatectomy (RDP) with laparoscopic distal pancreatectomy (LDP) and found that RDP had a lower conversion rate, a higher spleen preservation rate, and, in patients with PDAC, a higher lymph node yield and similar R0 resection rate. However, RDP was associated with higher costs.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Article
Surgery
S. Lof, N. van der Heijde, M. Abuawwad, B. Al-Sarireh, U. Boggi, G. Butturini, G. Capretti, A. Coratti, R. Casadei, M. D'Hondt, A. Esposito, G. Ferrari, G. Fusai, A. Giardino, B. Groot Koerkamp, T. Hackert, S. Kamarajah, E. F. Kauffmann, T. Keck, R. Marudanayagam, F. Nickel, A. Manzoni, P. Pessaux, A. Pietrabissa, E. Rosso, R. Salvia, Z. Soonawalla, S. White, A. Zerbi, M. G. Besselink, M. Abu Hilal
Summary: A multicentre international propensity score-matched study found that there was no significant difference in major morbidity rates between robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP). However, RDP showed better conversion rates, spleen preservation rates, and readmission rates compared to LDP.
BRITISH JOURNAL OF SURGERY
(2021)
Article
Gastroenterology & Hepatology
Mushegh A. Sahakyan, Tore Tholfsen, Dyre Kleive, Sheraz Yaqub, Airazat M. Kazaryan, Trond Buanes, Bard Ingvald Rosok, Knut Jorgen Labori, Bjorn Edwin
Summary: This study investigates the impact of prior upper abdominal surgery (PUAS) on laparoscopic distal pancreatectomy (LDP). The results show that while PUAS does not impair the feasibility and safety of LDP, open PUAS increases the burden and severity of postoperative complications.
JOURNAL OF GASTROINTESTINAL SURGERY
(2021)
Article
Surgery
Fabio Ausania, Filippo Landi, Carolina Gonzalez-Abos, John B. Martinie, Dionisios Vrochides, Matthew Walsh, Shanaz M. Hossain, Steven White, Viswakumar Prabakaran, Laleh G. Melstrom, Yuman Fong, Valentina Valle, Yuntao Bing, Dianrong Xiu, Gregorio Di Franco, Nicola De' Angelis, Alexis Laurent, Giuseppe Giuliani, Graziano Pernazza, Riccardo Memeo, Jose Rios, Andrea Coratti, Luca Morelli, Pier C. Giulianotti
Summary: Comparing robotic distal pancreatectomy (RDP) with laparoscopic distal pancreatectomy (LDP) in obese patients with PDAC, RDP showed improved perioperative outcomes and fewer severe complications.
INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY
(2023)
Article
Surgery
Yuanchi Weng, Jiabin Jin, Zhen Huo, Yusheng Shi, Yu Jiang, Xiaxing Deng, Chenghong Peng, Baiyong Shen
Summary: Robotic-assisted distal pancreatectomy has advantages in operative time, blood loss, spleen preservation, infection rate, and gastrointestinal function recovery over open distal pancreatectomy for treating benign and low-grade malignant pancreatic tumors.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Surgery
Lihan Qian, Binwei Hu, Jiancheng Wang, Xiongxiong Lu, Xiaxing Deng, Weimin Chai, Zhiwei Xu, Weishen Wang, Baiyong Shen
Summary: This study investigated the impact of remnant pancreas and other perioperative factors on postoperative pancreatic fistula (POPF) occurring after robot-assisted distal pancreatectomy (RDP) for nonmalignant pancreatic neoplasms. The results showed that a transection plan involving the tail of the pancreas and spleen preservation independently increased the incidence of POPF. The length of the remnant pancreas was also found to be a risk factor for POPF.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Article
Oncology
Atsushi Oba, Aya Maekawa, Yosuke Inoue, Rie Makuuchi, Kojiro Omiya, Kosuke Kobayashi, Yoshihiro Ono, Takafumi Sato, Manabu Ohashi, Hiromichi Ito, Souya Nunobe, Yu Takahashi
Summary: This study evaluated the short-term outcomes of distal pancreatectomy (DP) in patients who had previously undergone distal gastrectomy (DG) and introduced a robotic splenic vessels preserving DP (R-SPDP) method for safely preserving the remnant stomach.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Surgery
Clement Ferrier, Marjolaine Le Gac, Kamila Kolanska, Anne-Sophie Boudy, Yohan Dabi, Cyril Touboul, Sofiane Bendifallah, Emile Darai
Summary: This study compared the outcomes of robotic-assisted and conventional laparoscopic surgeries for colorectal endometriosis. The results showed that robotic surgery had lower intraoperative complication rate and higher rate of healthy margins in discoid and segmental resections. However, there were no significant differences between the two surgical approaches in complications, blood loss, re-hospitalization, and surgical revision for other colorectal procedures.
INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY
(2022)
Review
Oncology
Chuwen Chen, Jing Hu, Hao Yang, Xuejun Zhuo, Qiuping Ren, Qingbo Feng, Miye Wang
Summary: This study aimed to compare the safety and overall effect of robotic distal pancreatectomy (RDP) to laparoscopic distal pancreatectomy (LDP), particularly in terms of perioperative outcome and short-term oncological outcome. The results showed that RDP was associated with smaller tumor size, higher spleen preservation rate, and lower rate of conversion to open surgery compared to LDP. No significant differences were found in other outcomes between RDP and LDP.
FRONTIERS IN ONCOLOGY
(2022)
Article
Surgery
Jun Ishida, Hirochika Toyama, Ippei Matsumoto, Sachiyo Shirakawa, Sachio Terai, Hironori Yamashita, Hiroaki Yanagimoto, Sadaki Asari, Masahiro Kido, Takumi Fukumoto
Summary: Glucose tolerance improved after PD but worsened after DP. Insulin secretion decreased after both PD and DP. Insulin resistance improved after PD but did not change after DP. Further studies are needed to understand the mechanisms behind improved insulin resistance after PD.
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
(2021)
Review
Medicine, General & Internal
Atsushi Shimizu, Miwa Ito, Alan Kawarai Lefor
Summary: Hepatic surgery, including open, laparoscopic, and robot-assisted procedures, has rapidly developed in the field of abdominal surgery. Laparoscopic and robot-assisted surgery have shown comparable outcomes to open surgery for liver diseases. Robot-assisted surgery is gradually being accepted and used for the treatment of both benign and malignant conditions, with maintained outcomes.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Surgery
Matteo De Pastena, Eduard A. van Bodegraven, Timothy H. Mungroop, Frederique L. Vissers, Leia R. Jones, Giovanni Marchegiani, Alberto Balduzzi, Sjors Klompmaker, Salvatore Paiella, Shazad Tavakoli Rad, Bas Groot Koerkamp, Casper van Eijck, Olivier R. Busch, Ignace de Hingh, Misha Luyer, Caleb Barnhill, Thomas Seykora, Trudeau T. Maxwell, Thijs de Rooij, Massimiliano Tuveri, Giuseppe Malleo, Alessandro Esposito, Luca Landoni, Luca Casetti, Adnan Alseidi, Roberto Salvia, Ewout W. Steyerberg, Mohammad Abu Hilal, Charles M. Vollmer, Marc G. Besselink, Claudio Bassi
Summary: The study aimed to develop two distinct preoperative and intraoperative risk scores for predicting postoperative pancreatic fistula (POPF) after distal pancreatectomy (DP) to improve preventive and mitigation strategies. Two prediction risk scores were designed using multivariable logistic regression, with the preoperative score for preventive strategies and the intraoperative score for mitigation strategies. Internal and internal-external validations were conducted, and the risk scores were validated as the first of their kind for POPF after DP.
Article
Surgery
Elisa Bannone, Giovanni Marchegiani, Charles Vollmer, Giampaolo Perri, Giuseppa Procida, Gaetano Corvino, Sara Peressotti, Pier Giuseppe Vacca, Roberto Salvia, Claudio Bassi
Summary: This study aimed to evaluate the impact of postoperative serum hyperamylasemia (POH), with drain fluid amylase (DFA) and C-reactive protein (CRP), on the accuracy of the Fistula Risk Score (FRS) in assessing the risk of postoperative pancreatic fistula (POPF). The results showed that POH was an independent predictor of POPF and adding POH to the FRS improved the predictive accuracy.
Review
Surgery
Giampaolo Perri, Giovanni Marchegiani, Federico Reich, Luca Casetti, Martina Fontana, Alessandro Esposito, Andrea Ruzzenente, Roberto Salvia, Claudio Bassi
Summary: This study provides an overview of the current practice of intraoperative blood loss estimation in hepato-pancreato-biliary surgery. The findings suggest that the method of blood loss estimation is not standardized and calls for urgent standardization to ensure consistency and reproducibility.
Article
Gastroenterology & Hepatology
N. Surci, C. Bassi, R. Salvia, G. Marchegiani, L. Casetti, G. Deiro, C. Bergmann, K. Walenta, D. Tamandl, M. Schindl, K. Sahora, J. Muehlbacher
Summary: This study evaluated the impact of surgery on patients with chronic pancreatitis. The results showed that surgery can relieve pain, but it has a negative effect on pancreatic function and does not significantly influence nutritional status.
Article
Surgery
Syed S. Raza, Anisa Nutu, Sarah Powell-Brett, Alessio Marchetti, Giampaolo Perri, Amanda Carvalheiro Boteon, James Hodson, Nikolaos Chatzizacharias, Bobby Dasari, John Isaac, Manual Abradelo, Ravi Marudanayagam, Darius F. Mirza, J. Keith Roberts, Giovanni Marchegiani, Roberto Salvia, Robert P. Sutcliffe
Summary: This study aimed to identify early postoperative variables that may predict the severity of postoperative pancreatic fistula. The study found that male sex, drain fluid amylase level on postoperative day 3, c-reactive protein level on postoperative day 3, and albumin level on postoperative day 3 were significant predictors of clinically relevant postoperative pancreatic fistula.
Article
Pathology
Claudio Luchini, Paola Mattiolo, Olca Basturk, Andrea Mafficini, Kerem Ozcan, Rita T. Lawlor, Seung-Mo Hong, Lodewijk A. Brosens, Giovanni Marchegiani, Antonio Pea, Erminia Manfrin, Giuseppe Sciacca, Federica Zampieri, Rita Polati, Riccardo De Robertis, Michele Milella, Mirko D'Onofrio, Giuseppe Malleo, Roberto Salvia, Volkan Adsay, Aldo Scarpa
Summary: Acinar cystic transformation (ACT) of the pancreas is a poorly understood and rare entity among pancreatic cystic lesions. This study aims to clarify its real nature by describing the clinicopathological features and molecular profile of a cohort of 25 patients with pancreatic ACT. The findings suggest that ACT is a benign entity potentially arising from diverse conditions/backgrounds, but the presence of driver mutations raises the possibility of long-term surveillance for these patients.
AMERICAN JOURNAL OF SURGICAL PATHOLOGY
(2023)
Article
Gastroenterology & Hepatology
Matteo De Pastena, Elisa Bannone, Elena Andreotti, Chiara Filippini, Marco Ramera, Alessandro Esposito, Roberto Salvia
Summary: Robot-assisted pancreatoduodenectomy (R-PD) has the potential to provide benefits but also poses challenges for pancreatic-enteric anastomosis. This study aims to describe different management strategies and surgical techniques for standardized pancreatic-enteric anastomosis during an R-PD. The study reported the robotic technical steps of various modified pancreatic-enteric anastomosis techniques. Future studies should focus on personalized approaches after adequate risk stratification.
Article
Surgery
Giuseppe Malleo, Laura Maggino, Gabriella Lionetto, Alex Patton, Salvatore Paiella, Antonio Pea, Alessandro Esposito, Luca Casetti, Claudio Luchini, Aldo Scarpa, Claudio Bassi, Roberto Salvia
Summary: This study analyzed a large dataset without any censored events to evaluate the survival outcomes of pancreatic ductal adenocarcinoma patients after pancreatectomy. The results showed a 5-year empirical survival rate of 27.5% and a time-varying structure of prognostic variables. Unobserved tumor characteristics were found to have a substantial impact on disease progression.
Editorial Material
Gastroenterology & Hepatology
Giampaolo Perri, Giovanni Marchegiani
Article
Surgery
Sanne Lof, Linda Claassen, Gerjon Hannink, Bilal Al-Sarireh, Bergthor Bjornsson, Ugo Boggi, Fernando Burdio, Giovanni Butturini, Giovanni Capretti, Riccardo Casadei, Safi Dokmak, Bjorn Edwin, Alessandro Esposito, Jean M. Fabre, Giovanni Ferrari, Asmund A. Fretland, Fadhel S. Fteriche, Giuseppe K. Fusai, Alessandro Giardino, Bas Groot Koerkamp, Mathieu D'Hondt, Asif Jah, Sivesh K. Kamarajah, Emanuele F. Kauffmann, Tobias Keck, Stijn van Laarhoven, Alberto Manzoni, Marco V. Marino, Ravi Marudanayagam, Izaak Q. Molenaar, Patrick Pessaux, Edoardo Rosso, Roberto Salvia, Zahir Soonawalla, Regis Souche, Steven White, Frans van Workum, Alessandro Zerbi, Camiel Rosman, Martijn W. J. Stommel, Mohammed Abu Hilal, Marc G. Besselink
Summary: Understanding the learning curve of MIDP is important in reducing patient harm. This multicenter study analyzed data from 26 European centers to evaluate the length of the learning curve. The findings suggest that 85 procedures are needed to achieve optimal outcomes, while earlier mastery can be achieved for conversion rate, operation time, and intraoperative blood loss.
Article
Surgery
Ugo Boggi, Greta F. Donisi, Niccolo F. Napoli, Stefano Partelli, Alessandro Esposito, Giovanni Ferrari, Giovanni Butturini, Luca Morelli, Mohammad Abu Hilal, Massimo Viola, Fabrizio Di Benedetto, Roberto Troisi, Marco Vivarelli, Elio Jovine, Alessandro Ferrero, Umberto Bracale, Sergio Alfieri, Riccardo Casadei, Giorgio Ercolani, Luca Moraldi, Carlo Molino, Raffaele Dalla Valle, Giuseppe Ettorre, Riccardo L. Memeo, Giacomo Zanus, Andrea Belli, Salvatore Gruttadauria, Alberto Brolese, Andrea Coratti, Gianluca Garulli, Renato Romagnoli, Marco Massani, Felice Borghi, Giulio Belli, Roberto Coppola, Massimo Falconi, Roberto Salvia, Alessandro Zerbi, IGOMPIS registry
Summary: This retrospective analysis of the IGOMIPS registry in Italy examined 1191 minimally invasive pancreatic resections with various procedures. The study found that robotic assistance improved surgical outcomes and reduced complications. High-volume centers and standardized pathology were also associated with better results. Further research is needed to fully understand the implementation of MIPR in Italy.
UPDATES IN SURGERY
(2023)
Article
Health Care Sciences & Services
Veronica Marinelli, Maria Angela Mazzi, Michela Rimondini, Olivia Purnima Danzi, Deborah Bonamini, Claudio Bassi, Roberto Salvia, Lidia Del Piccolo
Summary: Pancreatic cancer is a highly lethal malignancy and surgical resection is the only treatment option. However, preoperative anxiety significantly affects patients' quality of life and surgical outcomes. This observational study aimed to identify the socio-demographic, clinical, and psychological characteristics that contribute to preoperative anxiety and concerns in pancreatic cancer patients. The findings suggest that high anxiety levels are associated with more preoperative concerns, particularly related to surgical aspects. Depressive symptoms and trait anxiety were identified as risk factors for preoperative anxiety. Screening for psychological characteristics and providing support can help prevent the development of preoperative anxiety and surgery worries.
Article
Health Care Sciences & Services
Maarten Korrel, Leia R. Jones, Jony van Hilst, Gianpaolo Balzano, Bergthor Bjornsson, Ugo Boggi, Svein Olav Bratlie, Olivier R. Busch, Giovanni Butturini, Giovanni Capretti, Riccardo Casadei, Bjorn Edwin, Anouk M. L. H. Emmen, Alessandro Esposito, Massimo Falconi, Bas Groot Koerkamp, Tobias Keck, Ruben H. J. de Kleine, Dyre B. Kleive, Arto Kokkola, Daan J. Lips, Sanne Lof, Misha D. P. Luyer, Alberto Manzoni, Ravi Marudanayagam, Matteo de Pastena, Nicolo Pecorelli, John N. Primrose, Claudio Ricci, Roberto Salvia, Per Sandstrom, Frederique L. I. M. Vissers, Ulrich F. Wellner, Alessandro Zerbi, Marcel G. W. Dijkgraaf, Marc G. Besselink, Mohammad Abu Hilal
Summary: This is a non-inferiority trial comparing open distal pancreatectomy (ODP) with minimally invasive distal pancreatectomy (MIDP) in patients with resectable pancreatic cancer. The results show that MIDP is not inferior to ODP in terms of radical resection rates, and the postoperative outcomes and survival rates are comparable as well.
LANCET REGIONAL HEALTH-EUROPE
(2023)
Article
Oncology
Eran van Veldhuisen, Sjors Klompmaker, Quisette P. Janssen, Mohammed Abu Hilal, Adnan Alseidi, Alberto Balduzzi, Gianpaolo Balzano, Claudio Bassi, Frederik Berrevoet, Morgan Bonds, Olivier R. Busch, Giovanni Butturini, Kevin C. Conlon, Isabella M. Frigerio, Giuseppe K. Fusai, Johan Gagniere, Oonagh Griffin, Thilo Hackert, Asif Halimi, Tobias Keck, Joerg Kleeff, Ulla Klaiber, Knut J. Labori, Mickael Lesurtel, Giuseppe Malleo, Marco V. Marino, I. Quintus Molenaar, Michael B. Mortensen, Andrej Nikov, Michele Pagnanelli, Rupaly Pande, Per Pfeiffer, Daniel Pietrasz, Elena Rangelova, Keith J. Roberts, Antonio Sa Cunha, Roberto Salvia, Oliver Strobel, Timo Tarvainen, Johanna W. Wilmink, Bas Groot Koerkamp, Marc G. Besselink
Summary: This study aimed to evaluate the outcome of pancreatectomy after preoperative FOLFIRINOX chemotherapy, and found that this treatment is associated with favorable outcomes for patients with BRPC and LAPC. However, the number of preoperative chemotherapy cycles and the use of adjuvant chemotherapy are not related to survival rate.
ANNALS OF SURGICAL ONCOLOGY
(2023)