{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T09:29:09Z","timestamp":1749720549919,"version":"3.40.5"},"reference-count":35,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Malignant tumours within the proximal pancreas traditionally require pancreaticoduodenectomy (PD) for cure. For smaller lesions with borderline malignant potential the risk\/benefit of PD becomes difficult to justify. Robotic approaches to these lesions allow for parenchymal preserving resection with reduced complication profile without oncological compromise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A review of a single surgeons prospectively collated database across two institutions of consecutive robotic enucleations or parenchyma preserving resections of the proximal pancreas was performed between July 2018 and October 2021. Standard demographic data, preoperative variables, intraoperative parameters, post\u2010operative outcomes, morbidity and mortality were recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen patients (8 female and 5 male) underwent robotic enucleation (EN) (8) and\/or uncinectomy (UN) (5) in the proximal pancreas. Mean BMI was 32(kg\/m<jats:sup>2<\/jats:sup>). Three patients (21%) underwent preoperative prophylactic pancreatic duct stenting. One patient required conversion to open. The median operative time in the EN group was 170\u2009min (108\u2013224\u2009min) and the UN group was 160\u2009min (110\u2013204\u2009min). The majority (8) of lesions were pNETs. Three lesions were IPMNs, with 1 solitary fibrous tumour and a serous cystic neoplasm (SCN) respectively. Median tumour size was 23\u2009mm (11\u201358\u2009mm) in the EN group, and 27\u2009mm (17\u201338\u2009mm) in the UN group. Ten of 13 patients had an R0 resection. There was no mortality in our series. Four (31%) patients across both groups developed clinically relevant POPF while none developed new endocrine or exocrine insufficiency. Average outpatient follow\u2010up has been 6\u2009months (1\u201318\u2009months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A robotic approach in proximal parenchymal preserving pancreatectomy is expanding, safe and feasible.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18719","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T20:03:25Z","timestamp":1696536205000},"page":"2897-2903","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robotic enucleation &amp; uncinectomy of complex lesions of the proximal pancreas"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0579-9355","authenticated-orcid":false,"given":"Nicholas","family":"Bell\u2010Allen","sequence":"first","affiliation":[{"name":"Department of HPB Surgery Royal Brisbane &amp; Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1551-3338","authenticated-orcid":false,"given":"Bartholomew","family":"McKay","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery Royal Brisbane &amp; Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Kilburn","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery Royal Brisbane &amp; Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2947-9206","authenticated-orcid":false,"given":"Peadar","family":"Waters","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery Royal Brisbane &amp; Women's Hospital  Brisbane Queensland Australia"},{"name":"Department of Surgery Cork University Hospital  Cork Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Cavallucci","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery Royal Brisbane &amp; Women's Hospital  Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-017-5523-z"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-012-1893-7"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9819"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14673"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10221"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gassur.2006.08.018"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-011-2045-0"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6576-3"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/145749690909800208"},{"key":"e_1_2_8_11_1","first-page":"674","article-title":"The da Vinci robotic system for general surgical applications: a critical interim appraisal","volume":"135","author":"Bodner J","year":"2005","journal-title":"Swiss Med. 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