Robotic Pancreatoduodenectomy

  • Pier Cristoforo Giulianotti
  • Federico Gheza


Pancreatoduodenectomy (PD) represents a challenging scenario for a minimally invasive approach, and the pure laparoscopic surgery is performed in few centers around the world.

Our experience with robotic pancreatic resections started more than 15 years ago1 and since then a great effort to standardize the technique has been done. The advantages of the robot can be mostly appreciated during the uncinate process dissection, the lymphadenectomy and the reconstructive phase. We herein describe our technique, in particular for pylorus preserving PD with different options for the pancreatic anastomosis.


Robotic surgery Pancreatoduodenectomy Whipple Pylorus-preserving pancreatoduodenectomy PPPD Pancreaticogastrostomy Pancreatojejunostomy 


  1. 1.
    Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T, Caravaglios G. Robotics in general surgery: personal experience in a large community hospital. Arch Surg. 2003;138:777–84.CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Kutlu OC, Lee JE, Katz MH, Tzeng CD, Wolff RA, Varadhachary GR, et al. Open pancreaticoduodenectomy case volume predicts outcome of laparoscopic approach: a population-based analysis. Ann Surg. 2018;267(3):552–60.CrossRefPubMedCentralGoogle Scholar
  3. 3.
    Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc. 1994;8:408–10.CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Fong ZV, Chang DC, Ferrone CR, Lillemoe KD, Fernandez Del Castillo C. Early national experience with laparoscopic pancreaticoduodenectomy for ductal adenocarcinoma: is this really a short learning curve? J Am Coll Surg. 2016;222:209.CrossRefPubMedCentralGoogle Scholar
  5. 5.
    Kim JH, Gonzalez-Heredia R, Daskalaki D, Rashdan M, Masrur M, Giulianotti PC. Totally replaced right hepatic artery in pancreaticoduodenectomy: is this anatomical condition a contraindication to minimally invasive surgery? HPB (Oxford). 2016;18:580–5.CrossRefGoogle Scholar
  6. 6.
    Miura F, Asano T, Amano H, Yoshida M, Toyota N, Wada K, et al. Management of postoperative arterial hemorrhage after pancreato-biliary surgery according to the site of bleeding: re-laparotomy or interventional radiology. J Hepato-Biliary-Pancreat Surg. 2009;16:56–63.CrossRefGoogle Scholar
  7. 7.
    Giulianotti PC, Addeo P, Buchs NC, Ayloo SM, Bianco FM. Robotic extended pancreatectomy with vascular resection for locally advanced pancreatic tumors. Pancreas. 2011;40:1264–70.CrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of General, Minimally Invasive and Robotic Surgery, Department of SurgeryUniversity of Illinois at ChicagoChicagoUSA

Personalised recommendations