{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:44:39Z","timestamp":1785833079776,"version":"3.56.0"},"reference-count":55,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite the growing adoption of robotic pancreatoduodenectomy (R\u2010PD), there remains a paucity of literature examining the learning curve associated with R\u2010PD and the comparison of outcomes between early and later phases of institutional experience in R\u2010PD. Accordingly, this study analyses 100 consecutive R\u2010PD cases at a tertiary centre in Singapore, comparing outcomes across the initial and subsequent 50 cases to assess the effect of the learning curve, and benchmarking low\u2010risk patients against international open PD (O\u2010PD) standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study is a post hoc review of 210 consecutive patients who underwent minimally\u2010invasive PD (MI\u2010PD) between 2016 and 2025, of which 100 patients who underwent MI\u2010PD with robotic assistance (R\u2010PD) were included. Baseline characteristics and perioperative outcomes were identified, and univariate analyses were conducted to evaluate differences between the first 50 cases (Group 1) and subsequent 50 cases (Group 2). Benchmarking was also performed for low\u2010risk cases against known O\u2010PD cut\u2010offs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Comparison between Groups 1 and 2 demonstrated a significant decrease in major postoperative complications (46% vs. 24%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), clinically significant post\u2010operative pancreatic fistula (Grade B\/C POPF) (39.1% vs. 18.2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05), POPF graded Clavien\u2010Dindo Grade 3 and above (21.7% vs. 4.5%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and delayed gastric emptying (46% vs. 14%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.00). Following risk stratification, Group 2 achieved ten of 11 benchmarks, compared with five of 11 in Group 1.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study supports the safe and effective implementation of R\u2010PD within a high\u2010volume hepatopancreatobiliary programme. Outcomes improved substantially after 50 cases, with low\u2010risk patients in Group 2 achieving nearly all international O\u2010PD benchmarks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70897","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T07:51:33Z","timestamp":1785829893000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adoption of Robotic Pancreatoduodenectomy: Initial Experience With the First 100 Consecutive Cases"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7931-5333","authenticated-orcid":false,"given":"Yoshio","family":"Masuda","sequence":"first","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore  Singapore Singapore"},{"name":"Ministry of Health Holdings  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3105-7472","authenticated-orcid":false,"given":"Bryant","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore  Singapore Singapore"},{"name":"Ministry of Health Holdings  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellis","family":"Cheong","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore  Singapore Singapore"},{"name":"Ministry of Health Holdings  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7090-3972","authenticated-orcid":false,"given":"Zhongkai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore  Singapore Singapore"},{"name":"Surgery Academic Clinical Programme Duke\u2010National University of Singapore Medical School  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5988-0132","authenticated-orcid":false,"given":"Hwee\u2010Leong","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore  Singapore Singapore"},{"name":"Surgery Academic Clinical Programme Duke\u2010National University of Singapore Medical School  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0707-338X","authenticated-orcid":false,"given":"Darren W.","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore  Singapore Singapore"},{"name":"Surgery Academic Clinical Programme Duke\u2010National University of Singapore Medical School  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5949-4741","authenticated-orcid":false,"given":"Ek\u2010Khoon","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore  Singapore Singapore"},{"name":"Surgery Academic Clinical Programme Duke\u2010National University of Singapore Medical School  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye\u2010Xin","family":"Koh","sequence":"additional","affiliation":[{"name":"Department of Hepatopancreatobiliary and Transplant Surgery Singapore General Hospital and National Cancer Centre Singapore  Singapore Singapore"},{"name":"Surgery Academic Clinical Programme Duke\u2010National University of Singapore Medical School  Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8218-4576","authenticated-orcid":false,"given":"Brian K. 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