A structured training program for robotic pancreatoduodenectomy (RPD) demonstrated feasibility, improving technical skills and outcomes among 20 European centers previously inexperienced in RPD.

• A total of 486 RPD procedures revealed a conversion rate of 18.3% and a major complication rate (Clavien-Dindo grade ≥III) of 31.4%.
• Training significantly improved Objective Structured Assessment of Technical Skills (OSATS) scores and reduced reconstruction time.

Structured, supervised training in a team setting is crucial for safely adopting complex robotic procedures, although a learning curve for complications still remains.