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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Review

Robotic Pancreaticoduodenectomy: Current Evidence and Future Perspectives

by
Silvio Caringi
1,2,*,
Antonella Delvecchio
1,3,
Annachiara Casella
1,
Cataldo De Palma
4,
Valentina Ferraro
1,
Rosalinda Filippo
1,
Matteo Stasi
1,
Nunzio Tralli
1,
Tommaso Maria Manzia
5,
Riccardo Memeo
1,3 and
Michele Tedeschi
1,3
1
Unit of Hepato-Biliary and Pancreatic Surgery, “F. Miulli” General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy
2
Department of Surgery, Università Degli Studi Roma “Tor Vergata”, Via Montpellier 1, 00133 Rome, Italy
3
Department of Medicine and Surgery, LUM University, 70010 Casamassima, Italy
4
Pancreatic Surgery, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
5
Department of Surgery Sciences, Transplant and HPB Unit, University of Rome Tor Vergata, 00133 Rome, Italy
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(23), 8372; https://doi.org/10.3390/jcm14238372
Submission received: 1 November 2025 / Revised: 22 November 2025 / Accepted: 24 November 2025 / Published: 25 November 2025
(This article belongs to the Special Issue State of the Art in Hepato-Pancreato-Biliary (HPB) Surgery)
Versions Notes

Abstract

Background: Robotic pancreaticoduodenectomy (RPD) is a less invasive alternative to open pancreaticoduodenectomy (OPD) with the potential for perioperative advantage. Concerns remain regarding its technical difficulty, cost, and oncologic adequacy. Methods: Review of PubMed, MEDLINE, Scopus, and Embase databases was conducted (January 2000–October 2025), focusing on systematic reviews, meta-analyses, and significant comparative studies of RPD. Outcomes assessed were perioperative outcomes, oncologic sufficiency, learning curve, model training, cost-effectiveness, and future developments. Results: Several studies report comparable R0 rates and lymph node yield between RPD and OPD, with reduced blood loss, shorter postoperative hospital stay, and faster recovery in high-volume centers. Morbidity (35–50%) and 90-day mortality (<2%) are similar to open or laparoscopic surgery. Competence is usually achieved after 40–60 cases, while optimal outcomes are achieved after 80–100 procedures. Structured mentorship and simulation training improve safety and reproducibility. Novel technologies such as augmented reality, intraoperative fluorescence, and artificial intelligence-based navigation may also enhance accuracy and shorten the learning curve. Conclusions: RPD appears to be a safe and effective minimally invasive option in carefully selected patients if done in specialized, high-volume centers. Future studies need to resolve long-term oncologic results, cost-effectiveness, and the role of next-generation robotic systems.
Keywords: robotic pancreaticoduodenectomy; minimally invasive surgery; pancreatic cancer surgery robotic pancreaticoduodenectomy; minimally invasive surgery; pancreatic cancer surgery

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MDPI and ACS Style

Caringi, S.; Delvecchio, A.; Casella, A.; De Palma, C.; Ferraro, V.; Filippo, R.; Stasi, M.; Tralli, N.; Manzia, T.M.; Memeo, R.; et al. Robotic Pancreaticoduodenectomy: Current Evidence and Future Perspectives. J. Clin. Med. 2025, 14, 8372. https://doi.org/10.3390/jcm14238372

AMA Style

Caringi S, Delvecchio A, Casella A, De Palma C, Ferraro V, Filippo R, Stasi M, Tralli N, Manzia TM, Memeo R, et al. Robotic Pancreaticoduodenectomy: Current Evidence and Future Perspectives. Journal of Clinical Medicine. 2025; 14(23):8372. https://doi.org/10.3390/jcm14238372

Chicago/Turabian Style

Caringi, Silvio, Antonella Delvecchio, Annachiara Casella, Cataldo De Palma, Valentina Ferraro, Rosalinda Filippo, Matteo Stasi, Nunzio Tralli, Tommaso Maria Manzia, Riccardo Memeo, and et al. 2025. "Robotic Pancreaticoduodenectomy: Current Evidence and Future Perspectives" Journal of Clinical Medicine 14, no. 23: 8372. https://doi.org/10.3390/jcm14238372

APA Style

Caringi, S., Delvecchio, A., Casella, A., De Palma, C., Ferraro, V., Filippo, R., Stasi, M., Tralli, N., Manzia, T. M., Memeo, R., & Tedeschi, M. (2025). Robotic Pancreaticoduodenectomy: Current Evidence and Future Perspectives. Journal of Clinical Medicine, 14(23), 8372. https://doi.org/10.3390/jcm14238372

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