Background

Aims of this study were to describe the stepwise implementation and expansion of robotic HPB surgery in a high volume HPB unit in the Netherlands and to analyze clinical outcomes of all robotic liver resections and robotic pancreatoduodenectomies performed within this program.

Methods

After proctoring by expert international surgeons, HPB surgeons were introduced to robotic liver resection and robotic pancreatoduodenectomy in a stepwise fashion. Data from two prospective databases containing all consecutive patients who underwent robotic liver resection or robotic pancreatoduodenectomy between August 1st, 2015 and March 1st, 2019 were analyzed post hoc.

Results

In total, 77 consecutive robotic liver resections and 68 consecutive robotic pancreatoduodenectomies were performed. Five surgeons were consecutively introduced to robotic HPB surgery. Mean operative time for robotic liver resection was 160 ± 78 min. Mean operative time for robotic pancreatoduodenectomy was 420 ± 67 min. Operative times remained stable over time and were not affected by the introduction of new surgeons.

Conclusion

Stepwise implementation and expansion of robotic HPB surgery within one unit over a three-and-half year period is feasible and associated with good clinical outcomes. Despite introducing new surgeons to the technique, operative times, an indicator of the learning process, remained stable over time.

中文翻译：

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在荷兰大规模 HPB 实践中逐步实施机器人手术

背景

本研究的目的是描述在荷兰的高容量 HPB 单元中逐步实施和扩展机器人 HPB 手术，并分析在该计划内进行的所有机器人肝切除术和机器人胰十二指肠切除术的临床结果。

方法

在国际外科医生的指导下，HPB 外科医生逐步了解了机器人肝切除术和机器人胰十二指肠切除术。事后分析了来自两个前瞻性数据库的数据，这些数据库包含在 2015 年 8 月 1 日至 2019 年 3 月 1 日期间接受机器人肝切除术或机器人胰十二指肠切除术的所有连续患者。

结果

总共进行了 77 次连续机器人肝切除术和 68 次连续机器人胰十二指肠切除术。五位外科医生被连续介绍了机器人HPB手术。机器人肝切除术的平均手术时间为 160 ± 78 分钟。机器人胰十二指肠切除术的平均手术时间为 420 ± 67 分钟。手术时间随着时间的推移保持稳定，不受新外科医生的影响。

结论

在三年半的时间内在一个单位内逐步实施和扩展机器人 HPB 手术是可行的，并且与良好的临床结果相关。尽管该技术引入了新的外科医生，但作为学习过程指标的手术时间随着时间的推移保持稳定。