Is Kangduo robotic distal pancreatectomy more economically efficient and effective in postoperative outcomes compared to laparoscopic surgery? A propensity-matched analysis.

Robotic platforms, historically led by the da Vinci system, may reduce postoperative complications compared with laparoscopy, but higher costs have limited general adoption. The updated Kangduo Surgical Robot (KD-SR2000) system is a recently introduced robot-assisted endoscopic surgical device originally designed in China. We sought to compare perioperative outcomes and in-hospital costs of KD-SR2000 assisted distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP). From January 2017 to October 2025, a total of 257 patients were included. The final analysis included 170 patients who were selected through propensity score matching, with 58 patients having received a KD-SR2000 robotic-assisted approach and 112 patients LDP. The primary endpoints were inflammatory markers, operative time, blood loss, blood transfusion rate, conversion rate to open surgery, postoperative length of stay, clinically relevant postoperative pancreatic fistula rate, spleen preservation rate, and total in-hospital costs. After propensity score matching, the confounding factors between the two groups were well balanced. The KD-SR2000 group demonstrated a significantly lower inflammatory index, conversion rate to open surgery, operative blood loss, operative blood transfusion rate, operation time, alongside cost-effective hospitalization cost, compared to the LDP group, while still maintaining similar outcomes for spleen preservation rate, postoperative length of stay and clinically relevant postoperative pancreatic fistulas rates. The study concludes that the KD-SR2000 technique offers a distinct advantage over LDP by achieving comparable key surgical outcomes with significantly improved perioperative efficiency and cost-effectiveness.