Practical approaches to high-risk anastomoses in robotic pancreatoduodenectomy

Abstract

Background: Pancreatoduodenectomy (PD) is performed for the treatment of pancreatic head and periampullary tumors and is associated with relatively high postoperative morbidity and mortality. Traditionally conducted as open surgery, PD has evolved with the advent of minimally invasive techniques, including robotic-assisted approaches. Results: As reported in the literature, minimally invasive PD is becoming a safe and effective alternative surgical approach. Clinically relevant postoperative pancreatic complications, such as fistulas and hemorrhage, remain among the most challenging issues after PD, particularly in high-risk cases. There are several maneuvers that may reduce their incidence and mitigate their postoperative clinical impact. Conclusions: In this video, we describe strategies implemented at our center for high-risk PD cases, including some key tips and tricks.