The left posterior approach to the superior mesenteric artery during robotic pancreaticoduodenectomy offers excellent outcomes, including a high rate of R0 resection and manageable complication rates. In a series of 27 patients, median operative time was 582 minutes with 100 mL of median blood loss. The approach resulted in an R0 resection rate of 89% […]

Robotic hepatectomy in IWATE expert-level liver resections results in less blood loss and a shorter hospital stay compared to open surgery, without increasing major complications or mortality. In a matched cohort of 68 patients, robotic surgery had a median operative time of 240 minutes versus 206 minutes for open surgery (p = 0.002), lower estimated […]

In patients with advanced hepatocellular carcinoma who responded to systemic therapy, surgical resection significantly prolongs time to treatment failure compared to maintenance therapy. Median time to treatment failure was 20.4 months with surgery versus 11.8 months with maintenance therapy (hazard ratio 0.60; p=0.015). Adverse events were higher in the surgery group (39%) versus maintenance (21%), […]

Patients with pancreaticobiliary maljunction (PBM) have significantly worse recurrence-free survival following surgical resection for gallbladder carcinoma without hepaticojejunostomy. PBM is associated with a 2.10-fold increased risk of recurrence (95% CI 1.13-3.89, p=0.019) compared to non-PBM patients in the study population. Overall survival in palliative settings is also adversely impacted, with a hazard ratio of 3.10 […]

A counterclockwise, step-by-step approach for robotic pancreatoduodenectomy enhances surgical workflow and appears to reduce operative complications. Mean console time was 279 minutes across 150 procedures, with no conversions to open surgery. Major complications occurred in 13.3% of patients, with a postoperative pancreatic fistula rate of 6.7% and delayed gastric emptying in 23.3%. The 30- and […]

Surgeons are familiar with intraoperative cell salvage (ICS) but use it sparingly during liver resections for cancer due to concerns about tumor cell contamination, indicating a need for more robust oncological outcome data. 26 hepatopancreatobiliary surgeons reported moderate to high familiarity with ICS (23/26) and occasional use (23/26), but only 10 used it during liver […]

Utilizing an artery-first approach for distal pancreatectomy with celiac axis resection can effectively manage blood loss and maintain low mortality in pancreatic cancer surgery. In a study of 14 patients, R0 resection was achieved in all cases, with a 90-day mortality rate of 0%. The median operation time was 469 minutes, and median blood loss […]

A randomized trial reveals no significant cost benefit of robotic pancreatoduodenectomy compared to open surgery, despite higher intraoperative costs. Total hospital costs were similar: €30,956 for robotic vs. €28,271 for open (p=0.538). Robotic technique had significantly higher intraoperative costs (€11,906 vs. €6,451, p<0.001) but lower postoperative costs (€19,051 vs. €21,856). Health-related quality of life scores […]