Single-port (SP) robotic pancreatic surgery using the da Vinci SP system: A retrospective study on prospectively collected data in a consecutive patient cohort

Background: Single-port (SP) robotic systems have the advantages of multi-jointed wristed instruments and a fully wristed three-dimensional high-definition camera. SP robotic pancreatic surgery (SPRPS) is rarely reported because of its complexity and technical challenges. This study aimed to evaluate the feasibility of SPRPS using the new da Vinci SP system. Methods: The demographics and short-term outcomes of a consecutive series of patients who underwent SP robotic pancreatic enucleation, distal pancreatectomy, and pancreaticoduodenectomy between December 24, 2021, and February 23, 2022, were analyzed. Results: Twenty-three patients (eight men and 15 women; mean age, 39.7 years) were included in the study; 11 underwent SP robotic pancreatic enucleation, 11 underwent SP robotic distal pancreatectomy, and one under-went SP robotic pancreaticoduodenectomy. The mean operative time was 156.5 min, and the median estimated blood loss was 40.0 (interquartile range, 20.0-50.0) mL. No patient required conversion to laparotomy or blood transfusions. One patient in each of the three groups had grade B postoperative pancreatic fistula (POPF) and abdominal infection; they all recovered after conservative treatment. No patient had postoperative complications of grade C POPF, pancreatectomy hemorrhage, or major complications (Clavien grade >= 3). The mean length of postoperative length of hospital stay was 4.0 days. Pathological examination showed that all tumors were benign, and the mean largest tumor diameter was 2.8 cm. Conclusions: SPRPS using the da Vinci SP system is safe and feasible in selected patients. Further research and more surgical experience are needed to determine the indications for SPRPS.