ArticleSurgical endoscopy2024
Unplanned conversions of robotic pancreaticoduodenectomy: short-term outcomes and suggested stepwise approach for a safe conversion.
Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Conversion to open surgery during robotic pancreatoduodenectomy in surgical high-risk groups: patterns, risk factors, and outcomes in elderly and/or obese patients.Surgical endoscopy · 2026Observational
- Preliminary translational assessment of robotic surgery skills for vascular dissection: from simulator to in vivo porcine model.Journal of robotic surgery · 2026Article
- The breaking point in robotic pancreaticoduodenectomy: factors influencing conversion thresholds and early postoperative outcomes in a tertiary referral center.Surgical endoscopy · 2026Article
- Comparison of perioperative outcomes between robotic and laparoscopic pancreaticoduodenectomy: a single-center propensity score matching analysis.BMC surgery · 2026Article
- MyIntuitive telemetry identifies proficiency thresholds in robotic pancreaticoduodenectomy.Surgical endoscopy · 2026Article
- Tampa difficulty score: a scoring system for difficulty of robotic pancreaticoduodenectomy.Journal of robotic surgery · 2024Article
- A comparative analysis of robotic versus open pancreaticoduodenectomy in octogenarians.Journal of robotic surgery · 2024Article
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Authors and funding
8 authors.
Funding
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Abstract
objectiveWith the increased adoption of robotic pancreaticoduodenectomy, the effects of unplanned conversions to an 'open' operation are ill-defined. This study aims to describe the impact of unplanned conversions of robotic pancreaticoduodenectomy on short-term outcomes and suggest a stepwise approach for safe unplanned conversions during robotic pancreaticoduodenectomy.
methodsThis is an analysis of 400 consecutive patients undergoing robotic pancreaticoduodenectomy in a single high-volume institution. Data are presented as median (mean ± SD), and significance is accepted with 95% probability.
resultsBetween November 2012 and February 2023, 184 (46%) women and 216 (54%) men, aged 70 (68 ± 11.0) years, underwent a robotic pancreaticoduodenectomy. Unplanned conversions occurred in 42 (10.5%) patients; 18 (5%) were converted due to unanticipated vascular involvement, 13 (3%) due to failure to obtain definitive control of bleeding, and 11 (3%) due to visceral obesity. Men were more likely to require a conversion than women (29 vs. 13, p = 0.05). Conversions were associated with shorter operative time (376 (323 ± 182.2) vs. 434 (441 ± 98.7) min, p < 0.0001) but higher estimated blood loss (675 (1010 ± 1168.1) vs. 150 (196 ± 176.8) mL, p < 0.0001). Patients that required an unplanned conversion had higher rates of complications with Clavien-Dindo scores of III-V (31% vs. 12%, p = 0.003), longer length of stay (8 (11 ± 11.6) vs. 5 (7 ± 6.2), p = 0.0005), longer ICU length of stay (1 (2 ± 5.1) vs. 0 (0 ± 1.3), p < 0.0001) and higher mortality rates (21% vs. 4%, p = 0.0001). The conversion rate significantly decreased over time (p < 0.0001).
conclusionsUnplanned conversions of robotic pancreaticoduodenectomy significantly and negatively affect short-term outcomes, including postoperative mortality. Men were more likely to require a conversion than women. The unplanned conversions rates significantly decreased over time, implying that increased proficiency and patient selection may prevent unplanned conversions. An unplanned conversion should be undertaken in an organized stepwise approach to maximize patient safety.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.