{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T20:48:23Z","timestamp":1784580503442,"version":"3.55.0"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T00:00:00Z","timestamp":1748131200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T00:00:00Z","timestamp":1748131200000},"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":["Updates Surg"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Robotic pancreaticoduodenectomy (RPD) is increasingly recognized as a standard procedure due to its minimally invasive nature and associated benefits such as reduced blood loss and faster recovery. This paper presents a set of tips and tricks, focusing on the management of pancreatic and biliary sections, the application of the falciform ligament for vascular protection, and the precise positioning of drainage systems. Key strategies include the use of 4\/0 PDS stitches to control pancreatic vessel bleeding, preventing ischemia by refraining from the use of energy during pancreas dissection, and ensuring optimal drainage placement. The incorporation of a modified Blumgart anastomosis with a single-thread technique and the use of hydrogel sheets are also highlighted as crucial in reducing fistula formation. We think that these measures can significantly lower the incidence and severity of POPF and postoperative bleeding, thereby enhancing surgical outcomes. This paper aims to contribute to the growing body of knowledge on RPD, offering practical tips that can be safely and effectively integrated into routine clinical practice.<\/jats:p>","DOI":"10.1007\/s13304-025-02264-4","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T06:30:29Z","timestamp":1748154629000},"page":"1137-1140","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["How do it: tips and tricks during full-robotic pancreaticoduodenectomy"],"prefix":"10.1007","volume":"77","author":[{"given":"T.","family":"Piardi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7773-0971","authenticated-orcid":false,"given":"G.","family":"Badessi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. A.","family":"Biondo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Del Basso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,25]]},"reference":[{"issue":"2","key":"2264_CR1","doi-asserted-by":"publisher","first-page":"znae043","DOI":"10.1093\/bjs\/znae043","volume":"111","author":"N de Graaf","year":"2024","unstructured":"de Graaf N, Zwart MJW, van Hilst J, van den Broek B, Bonsing BA, Busch OR, Coene PLO, Daams F, van Dieren S, van Eijck CHJ, Festen S, de Hingh IHJT, Lips DJ, Luyer MDP, Mieog JSD, van Santvoort HC, van der Schelling GP, Stommel MWJ, de Wilde RF, Molenaar IQ, Groot Koerkamp B, Besselink MG (2024) Early experience with robotic pancreatoduodenectomy versus open pancreatoduodenectomy: nationwide propensity-score-matched analysis. Br J Surg. 111(2):znae043. https:\/\/doi.org\/10.1093\/bjs\/znae043. (PMID: 38415878; PMCID: PMC10898866)","journal-title":"Br J Surg."},{"issue":"5","key":"2264_CR2","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/S2468-1253(24)00005-0","volume":"9","author":"Q Liu","year":"2024","unstructured":"Liu Q, Li M, Gao Y, Jiang T, Han B, Zhao G, Lin C, Lau WY, Zhao Z, Liu R (2024) Effect of robotic versus open pancreaticoduodenectomy on postoperative length of hospital stay and complications for pancreatic head or periampullary tumours: a multicentre, open-label randomised controlled trial. Lancet Gastroenterol Hepatol. 9(5):428\u2013437. https:\/\/doi.org\/10.1016\/S2468-1253(24)00005-0. (Epub 2024 Feb 28 PMID: 38428441)","journal-title":"Lancet Gastroenterol Hepatol."},{"key":"2264_CR3","doi-asserted-by":"publisher","DOI":"10.1111\/ans.19147","author":"SA Biondo","year":"2024","unstructured":"Biondo SA, Kellil T, Tormane MA, Del Basso C, Giampaoli F, Piardi T (2024) How to do pancreatic transection during robotic pancreaticoduodenectomy. Is hanging manoeuvre always necessary? ANZ J Surg. https:\/\/doi.org\/10.1111\/ans.19147","journal-title":"ANZ J Surg"},{"issue":"1","key":"2264_CR4","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1093\/bjs\/znab363","volume":"109","author":"T Welsch","year":"2021","unstructured":"Welsch T, M\u00fcssle B, Korn S, Sturm D, Bork U, Distler M, Gr\u00e4hlert X, Klimova A, Trebesius N, Kleespies A, Kees S, Beckert S, Reim D, Friess H, Elwerr M, Kleeff J, Popescu O, Schmitz-Winnenthal H, Janot-Matuschek M, Uhl W, Weber GF, Brunner M, Golcher H, Gr\u00fctzmann R, Weitz J (2021) Pancreatoduodenectomy with or without prophylactic falciform ligament wrap around the hepatic artery for prevention of postpancreatectomy haemorrhage: randomized clinical trial (PANDA trial). Br J Surg. 109(1):37\u201345. https:\/\/doi.org\/10.1093\/bjs\/znab363. (PMID: 34746958)","journal-title":"Br J Surg."},{"issue":"4","key":"2264_CR5","doi-asserted-by":"publisher","first-page":"354","DOI":"10.1097\/AS9.0000000000000354","volume":"4","author":"JW Chen","year":"2023","unstructured":"Chen JW, Lof S, Zwart MJW, Busch OR, Daams F, Festen S, Fong ZV, Hogg ME, Slooter MD, Nieveen van Dijkum EJM, Besselink MG (2023) Intraoperative fluorescence imaging during robotic pancreatoduodenectomy to detect suture-induced hypoperfusion of the pancreatic stump as a predictor of postoperative pancreatic fistula (FLUOPAN) prospective proof-of-concept study. Ann Surg Open. 4(4):354. https:\/\/doi.org\/10.1097\/AS9.0000000000000354. (PMID: 38144496; PMCID: PMC10735109)","journal-title":"Ann Surg Open."},{"key":"2264_CR6","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1097\/SLA.0000000000005226","volume":"275","author":"G Marchegiani","year":"2022","unstructured":"Marchegiani G, Barreto SG, Bannone E et al (2022) Postpancreatectomy acute pancreatitis (PPAP): de nition and grading from the international study group for pancreatic surgery (ISGPS). Ann Surg 275:663\u201372","journal-title":"Ann Surg"}],"container-title":["Updates in Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13304-025-02264-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13304-025-02264-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13304-025-02264-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,6]],"date-time":"2025-09-06T16:59:57Z","timestamp":1757177997000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13304-025-02264-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,25]]},"references-count":6,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["2264"],"URL":"https:\/\/doi.org\/10.1007\/s13304-025-02264-4","relation":{},"ISSN":["2038-131X","2038-3312"],"issn-type":[{"value":"2038-131X","type":"print"},{"value":"2038-3312","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,25]]},"assertion":[{"value":"9 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}