Laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD) are minimally invasive surgical approaches for performing a pancreaticoduodenectomy (Whipple procedure), a complex operation to treat pancreatic head tumors, periampullary tumors, or other conditions. Here’s a concise comparison based on available evidence, focusing on key aspects such as outcomes, advantages, and limitations:
Overview
Comparison
Aspect | Laparoscopic (LPD) | Robotic (RPD) |
---|---|---|
Visualization | 2D imaging, less depth perception. | 3D high-definition imaging, better depth perception. |
Instrument Dexterity | Limited by rigid instruments, tremor amplification. | Articulated instruments, tremor filtration, greater precision. |
Learning Curve | Steeper; requires advanced laparoscopic skills. | Less steep; robotic interface is more intuitive. |
Operative Time | Often longer due to technical challenges. | May be shorter with experience, but setup time longer. |
Blood Loss | Comparable or slightly higher than RPD. | Comparable or slightly lower due to precision. |
Postoperative Outcomes | Similar complication rates (e.g., pancreatic fistula, delayed gastric emptying). | Similar complication rates; some studies suggest lower fistula rates. |
Hospital Stay | Similar (typically 6–10 days). | Similar, with potential for slightly shorter stays. |
Cost | Lower equipment costs but higher skill demand. | Higher due to robotic system and maintenance. |
Oncologic Outcomes | Comparable margin-negative resection rates. | Comparable, with potential for improved lymph node retrieval. |
Conversion to Open Surgery | Higher risk due to technical limitations. | Lower risk due to enhanced control and visualization. |
Advantages
Limitations
Clinical Evidence
Current Trends and Considerations
Conclusion
Overview: Distal pancreatectomy involves surgical removal of the body and tail of the pancreas, often for tumors, cysts, or chronic pancreatitis. It can be performed via open surgery or minimally invasive techniques (laparoscopic or robotic-assisted). Below is a comparison based on procedure, outcomes, and considerations.
Open Distal Pancreatectomy
Minimally Invasive Distal Pancreatectomy (Laparoscopic or Robotic)
Key Comparisons
Factor | Open | Minimally Invasive |
---|---|---|
Incision Size | Large (10–20 cm) | Small (0.5–2 cm) |
Hospital Stay | 5–10 days | 3–7 days |
Recovery Time | 4–8 weeks | 2–4 weeks |
Wound Complications | Higher (5–10%) | Lower (2–5%) |
Operative Time | Shorter | Longer |
Cost | Lower | Higher (especially robotic) |
Oncologic Outcomes | Equivalent for resectable tumors | Equivalent for resectable tumors |
Spleen Preservation | Feasible but less common | More feasible, especially robotic |
Clinical Considerations
Current Trends
Conclusion
Laparoscopic and robotic distal pancreatectomy are minimally invasive surgical approaches for removing the distal (tail) portion of the pancreas. Both techniques aim to reduce complications, recovery time, and hospital stay compared to open surgery. Below is a comparison based on available evidence, focusing on key differences, advantages, and disadvantages.
Laparoscopic Distal Pancreatectomy (LDP)
Robotic Distal Pancreatectomy (RDP)
Comparative Outcomes (Based on Studies up to 2025)
Indications and Patient Selection
Current Trends and Evidence
Conclusion
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