Abstract：
Robotic distal pancreatectomy (RDP) has emerged as a minimally invasive approach to left-sided pancreatic tumors. This study aimed to evaluate the efficacy of the robot-assisted approach (RAA) using a laparoscopic articulating vessel-sealing device (LAVSD) during RDP by comparing it with the pure-robotic approach (PRA). Among 62 patients who underwent RDP between April 2020 and December 2023 at Fujita Health University, 22 underwent RAA (the RAA group). In RAA, console surgeons mainly prepared the surgical fields, and assistant surgeons actively dissected the adipose and connective tissues using LAVSD. The surgical outcomes of these patients were compared with those of 40 consecutive patients who underwent RDP with PRA. In total, 28 males and 34 females with a median age of 71 years were analyzed. The console surgeon\'s prior experience of performing RDP was similar between the groups (RAA; median, 6 [range, 0-36], PRA; median, 5.5 [range, 0-34] cases). The operation time was significantly shorter in the TST group (median, 300.5 [range, 202-557] vs. 363.5 [range, 230-556] min, p = 0.015). Major complications (Clavien-Dindo ≥ grade 3a) occurred less frequently in the RAA group (4.6% vs. 25.0%, p = 0.028). Although the median postoperative hospital stay was slightly shorter in the RAA group (median, 12 [range, 8-38] vs. 14.5 [8-44] days, p = 0.095), no statistically significant difference was observed. Compared with PRA, RAA using LAVSD is found to be safe and feasible in introducing RDP for operators with little experience.
摘要：
机器人远端胰腺切除术（RDP）已成为治疗左侧胰腺肿瘤的微创方法。这项研究旨在通过将其与纯机器人方法（PRA）进行比较，来评估在RDP期间使用腹腔镜铰接血管密封装置（LAVSD）的机器人辅助方法（RAA）的有效性。在2020年4月至2023年12月在藤田健康大学接受RDP的62名患者中，22例患者行RAA(RAA组)。在RAA,控制台外科医生主要准备手术区域，和助理外科医生使用LAVSD积极解剖脂肪和结缔组织。将这些患者的手术结果与40例接受PRARDP的连续患者的手术结果进行了比较。总的来说,分析了28名男性和34名女性，中位年龄为71岁。控制台外科医生先前进行RDP的经验在两组之间相似(RAA;中位数,6[范围,0-36],PRA；中位数，5.5[范围，0-34]例)。TST组手术时间明显缩短(中位数,300.5[范围，202-557]vs.363.5[范围，230-556]min,p=0.015)。RAA组的主要并发症（Clavien-Dindo≥3a级）发生率较低（4.6％vs.25.0%,p=0.028)。尽管RAA组的中位术后住院时间稍短（中位数，12[范围，8-38]vs.14.5[8-44]天，p=0.095),差异无统计学意义。与PRA相比,发现使用LAVSD的RAA在为经验不足的运营商引入RDP中是安全可行的。
