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Zureikat AH, Nguyen KT, Bartlett DL, Zeh HJ, Moser AJ. Robotic-Assisted Major Pancreatic Resection and Reconstruction. Arch Surg. 2011;146(3):256–261. doi:10.1001/archsurg.2010.246
Complex pancreatic resection remains the final frontier for minimally invasive surgery because of the twin technical challenges of controlling hemorrhage from major vessels and reconstructing the biliary and pancreatic ducts with acceptable morbidity. Despite recent data suggesting that complex pancreatic operations can be performed laparoscopically at high-volume centers,1-3 the use of traditional laparoscopic instruments has required that critical technical principles of open pancreatic surgery be modified to overcome the limitations of current technology. Examples include limited range of instrument motion, poor surgeon ergonomics, reliance on 2-dimensional imaging, and reduced dexterity, which precludes facile sewing with fine suture. Robotic-assisted minimally invasive surgery addresses many of the shortcomings of traditional laparoscopy and may permit complex anastomotic reconstruction to be performed with the same techniques as open surgery. Robotic-enhanced dexterity, binocular 3-dimensional imaging, 3-axis motion of surgical instruments, and improved ergonomics may allow difficult pancreatic resections to be accomplished with safety and efficacy equal to those of open surgery but with reduced time to recovery and potentially improved cancer-specific outcomes.
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