Achievement of international benchmark outcomes for robotic pancreaticoduodenectomy in a low volume country

Joel Lewin; Mehan Siriwardhane; Shinn Yeung

doi:10.1016/j.hpb.2024.10.003

Achievement of international benchmark outcomes for robotic pancreaticoduodenectomy in a low volume country

HPB (Oxford). 2024 Oct 17:S1365-182X(24)02331-1. doi: 10.1016/j.hpb.2024.10.003. Online ahead of print.

Authors

Joel Lewin¹, Mehan Siriwardhane², Shinn Yeung²

Affiliations

¹ Mater Hospital Brisbane, Raymond Terrace, South Brisbane, Queensland, Australia; Greenslopes Private Hospital, Newdegate St, Greenslopes, Queensland, Australia. Electronic address: joel.lewin@mater.org.au.
² Mater Hospital Brisbane, Raymond Terrace, South Brisbane, Queensland, Australia; Greenslopes Private Hospital, Newdegate St, Greenslopes, Queensland, Australia.

PMID: 39490336
DOI: 10.1016/j.hpb.2024.10.003

Abstract

Background: Recently, there has been an increase in the utilisation of the robotic platform to perform minimally invasive pancreaticoduodenectomy in high volume centres, with the goal of reducing morbidity and improving patient outcomes. This study reports the successful implementation of a robotic pancreaticoduodenectomy (RPD) programme in the relatively low volume setting of Australia, measured against established, internationally accepted benchmarks for low-risk open pancreaticoduodenectomy (OPD).

Methods: Retrospective review of a prospectively maintained database for consecutive RPD at two Brisbane hospitals was performed, comparing data to internationally established benchmarks for low-risk OPD. A structured RPD programme was implemented by two surgeons across a study period spanning May 2017 to December 2023.

Results: Over the study period, seventy-two consecutive RPDs were performed, with 79 % for malignancy. Perioperative outcomes for transfusions, conversion rate, postoperative fistula rate, morbidity, mortality and oncological outcomes were all within established benchmark cutoffs for low-risk open pancreaticoduodenectomy (OPD), although operative time exceeded the benchmark value by 0.7hrs.

Conclusion: A carefully implemented RPD programme in the low volume Australian setting is feasible, with high quality outcomes achievable when compared to established benchmarks for low-risk OPD and to reported RPD series published by high volume pioneering centres.