{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:54:51Z","timestamp":1791392091749,"version":"4.3.3"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Robotic pancreatic enucleation (rPE) has emerged as a parenchyma-sparing surgical approach for benign or low-grade malignant pancreatic lesions. However, standardized metrics to assess perioperative quality are lacking. This study aimed to propose an rPE-specific textbook outcome (rPE-TO) reflecting an ideal perioperative pathway and to evaluate its applicability in two independent institutional cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>Patients undergoing completed rPE at University Hospital Heidelberg, Germany, between April 2023 and March 2025 were analyzed, and the proposed rPE-TO was additionally evaluated in an independent institutional cohort from Johns Hopkins University, Maryland, USA. The rPE-TO comprised six components: no conversion to open surgery, no incomplete resection requiring reoperation, no clinically relevant postoperative pancreatic fistula (POPF), no major complications (Clavien\u2013Dindo &lt;\u00a0IIIa, with POPF assessed separately), no readmission within 30\u00a0days, and no mortality within 90\u00a0days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The Heidelberg cohort included 31 patients, of whom 20 (64.5%) achieved rPE-TO. Among the individual components, conversion to open surgery occurred in 4 patients (12.9%), incomplete resection requiring reoperation in 1 (3.2%), POPF in 6 (19.4%), major complications in 2 (6.5%), and 30-day readmission in 2 (6.5%); no 90-day mortality occurred. In the Johns Hopkins cohort (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200948), rPE-TO was achieved in 29 patients (60.4%). Despite comparable overall rPE-TO rates, the distribution of individual failure components differed between institutions. In addition, length of hospital stay was shorter among patients achieving rPE-TO in both cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Textbook outcome was achieved in approximately two thirds of patients undergoing rPE in both institutional cohorts. The proposed rPE-TO integrates established perioperative quality measures with procedure-specific outcomes and may provide a composite measure for assessing an ideal perioperative pathway after robotic pancreatic enucleation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13377-1","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:12:08Z","timestamp":1791389528000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Textbook outcome after robotic pancreatic enucleation: a two-center evaluation of an ideal perioperative pathway"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1221-6285","authenticated-orcid":false,"given":"Marionna","family":"Cathomas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zheng","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedict","family":"Kinny-K\u00f6ster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingmar","family":"Rompen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Gauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miriam","family":"Klau\u00df","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph W.","family":"Michalski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Loos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hank","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"issue":"1","key":"13377_CR1","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/j.surg.2015.03.023","volume":"158","author":"F Faitot","year":"2015","unstructured":"Faitot F, Gaujoux S, Barbier L, Novaes M, Dokmak S, Aussilhou B, Couvelard A, Rebours V, Ruszniewski P, Belghiti J et al (2015) Reappraisal of pancreatic enucleations: a single-center experience of 126 procedures. 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Michalski, Martin Loos, Jin He, and Thomas Hank have no conflicts of interest or financial ties to disclose.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}}]}}