How do it: tips and tricks during full-robotic pancreaticoduodenectomy.

IF 2.4 3区 医学 Q2 SURGERY
T Piardi, G Badessi, S A Biondo, C Del Basso
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引用次数: 0

Abstract

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.

怎么做:全机器人胰十二指肠切除术的技巧和技巧。
机器人胰十二指肠切除术(RPD)由于其微创性和相关的好处,如减少失血和更快的恢复,越来越被认为是一种标准手术。本文介绍了一套技巧和技巧,重点是胰腺和胆道的管理,镰状韧带血管保护的应用,以及引流系统的精确定位。关键策略包括使用4/0 PDS针来控制胰腺血管出血,在胰腺剥离过程中避免使用能量来防止缺血,并确保最佳引流位置。结合改良的Blumgart单线吻合技术和水凝胶片的使用也被强调为减少瘘形成的关键。我们认为这些措施可以显著降低POPF的发生率和严重程度以及术后出血,从而提高手术效果。本文旨在为不断增长的RPD知识体系做出贡献,提供可以安全有效地融入常规临床实践的实用技巧。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Updates in Surgery
Updates in Surgery Medicine-Surgery
CiteScore
4.50
自引率
7.70%
发文量
208
期刊介绍: Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future. Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts. Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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