Robotic pancreatectomy tied to fewer complications

In an instrumental-variable analysis of 55,514 Medicare pancreatectomies, robotic surgery was associated with better outcomes than open surgery, but not laparoscopy.

• Serious complications were 10.4% with robotic versus 16.8% with open surgery; reoperation was 5.7% versus 7.8%, and 90-day mortality 5.2% versus 7.7%.
• Ninety-day episode spending was also lower with robotic than open surgery.

Outcomes were better overall at high-volume centers, but did not differ by surgical approach at low-volume hospitals. These claims-based findings are not proof that the robotic approach caused better outcomes—and do not establish an advantage over laparoscopy.