Abstract：
BACKGROUND: The optimal approach for the safe implementation and education of robotic pancreaticoduodenectomy (RPD) remains unclear. Prolonged operation time may cause surgeon fatigue and result in perioperative complications. To solve this issue, our department adopted task division by the console surgeon turnover between resection and reconstruction in 2022.
METHODS: This study retrospectively investigated consecutive patients who underwent RPD from November 2009 (initial introduction of RPD) to December 2023. The analysis excluded patients who underwent concomitant resection of other organs. The cases performed by a single console surgeon (single approach) were compared with those performed by two or more console surgeons (multiple approach).
RESULTS: This study analyzed 85 consecutive RPD cases, including 51 with the single approach and 34 with the multiple approach. The operation time was significantly shorter (832 vs. 618 min, p < 0.001), and the postoperative major complication was less frequent (45% vs. 12%, p = 0.003) in the multiple approach group, although less experienced surgeons performed the multiple approach (number of RPD experiences: 19 cases vs. 5 cases, p < 0.001). The console surgeon turnover between the resection and reconstruction resulted in a safe pancreatojejunostomy performed by the less experienced surgeon (number of pancreatic reconstruction experiences: 6.5 vs. 14 cases, p = 0.010). Surgeons who started RPD with a multiple approach observed a reduction in surgical time and a lower incidence of complications earlier than those who started with a single approach.
CONCLUSIONS: Task division during the early introduction phase of RPD using the multiple approach demonstrated potential contributions to improved surgical outcomes and enhanced educational benefits.
METHODS: This study retrospectively investigated consecutive patients who underwent RPD from November 2009 (initial introduction of RPD) to December 2023. The analysis excluded patients who underwent concomitant resection of other organs. The cases performed by a single console surgeon (single approach) were compared with those performed by two or more console surgeons (multiple approach).
RESULTS: This study analyzed 85 consecutive RPD cases, including 51 with the single approach and 34 with the multiple approach. The operation time was significantly shorter (832 vs. 618 min, p < 0.001), and the postoperative major complication was less frequent (45% vs. 12%, p = 0.003) in the multiple approach group, although less experienced surgeons performed the multiple approach (number of RPD experiences: 19 cases vs. 5 cases, p < 0.001). The console surgeon turnover between the resection and reconstruction resulted in a safe pancreatojejunostomy performed by the less experienced surgeon (number of pancreatic reconstruction experiences: 6.5 vs. 14 cases, p = 0.010). Surgeons who started RPD with a multiple approach observed a reduction in surgical time and a lower incidence of complications earlier than those who started with a single approach.
CONCLUSIONS: Task division during the early introduction phase of RPD using the multiple approach demonstrated potential contributions to improved surgical outcomes and enhanced educational benefits.
摘要：
背景：机器人胰十二指肠切除术（RPD）的安全实施和教育的最佳方法仍不清楚。延长手术时间可能会导致外科医生疲劳并导致围手术期并发症。为了解决这个问题，我们部门在2022年采用了按控制台外科医生在切除和重建之间周转的任务划分。
方法：本研究回顾性调查了从2009年11月（首次引入RPD）到2023年12月连续接受RPD的患者。该分析排除了同时进行其他器官切除的患者。将由单个控制台外科医生（单个方法）执行的病例与由两个或更多个控制台外科医生（多个方法）执行的病例进行比较。
结果：本研究分析了85例连续RPD病例，其中51种采用单一方法，34种采用多重方法。手术时间明显缩短（832vs.618分钟,p<0.001)，术后主要并发症发生率较低(45%vs.12%,p=0.003)在多进组中，尽管经验较少的外科医生进行了多种方法（RPD经验数量：19例与5例,p<0.001)。手术切除和重建之间的控制台外科医生周转导致由经验较少的外科医生进行安全的胰肠吻合术（胰腺重建经验的数量：6.5vs.14例,p=0.010)。采用多种方法开始RPD的外科医生比采用单一方法开始RPD的外科医生观察到手术时间减少，并发症发生率更低。
结论：在RPD的早期引入阶段，使用多种方法的任务划分显示了对改善手术结果和提高教育效益的潜在贡献。
方法：本研究回顾性调查了从2009年11月（首次引入RPD）到2023年12月连续接受RPD的患者。该分析排除了同时进行其他器官切除的患者。将由单个控制台外科医生（单个方法）执行的病例与由两个或更多个控制台外科医生（多个方法）执行的病例进行比较。
结果：本研究分析了85例连续RPD病例，其中51种采用单一方法，34种采用多重方法。手术时间明显缩短（832vs.618分钟,p<0.001)，术后主要并发症发生率较低(45%vs.12%,p=0.003)在多进组中，尽管经验较少的外科医生进行了多种方法（RPD经验数量：19例与5例,p<0.001)。手术切除和重建之间的控制台外科医生周转导致由经验较少的外科医生进行安全的胰肠吻合术（胰腺重建经验的数量：6.5vs.14例,p=0.010)。采用多种方法开始RPD的外科医生比采用单一方法开始RPD的外科医生观察到手术时间减少，并发症发生率更低。
结论：在RPD的早期引入阶段，使用多种方法的任务划分显示了对改善手术结果和提高教育效益的潜在贡献。
