Laparoscopic and robotic distal pancreatectomy: the choice and the future

Espin Alvarez, Francisco; García-Domingo, María Isabel; Cremades Pérez, Manel; Cugat Andorra, Esteban

doi:10.1016/j.cireng.2024.02.003

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array:1 [ 0 => array:2 [ "paginaInicial" => "238" "paginaFinal" => "239" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Francisco Espin Alvarez, María Isabel García-Domingo, Manel Cremades Pérez, Esteban Cugat Andorra" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Francisco" "apellidos" => "Espin Alvarez" "email" => array:1 [ 0 => "fjespin.germanstrias@gencat.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "María Isabel" "apellidos" => "García-Domingo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Manel" "apellidos" => "Cremades Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Esteban" "apellidos" => "Cugat Andorra" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Cirugía Hepatobiliopancreática, Hospital Universitari Germans Trias i Pujol, Badalona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Cirugía Hepatobiliopancreática, Hospital Universitari Mútua de Terrassa, Terrassa, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "First of all, the authors would like to thank you for your comments and the analysis of the article.As it highlights, the implementation or incorporation of the robotic platform must follow the surgical principles and must demonstrate its effectiveness, efficiency, and safety, so we believe and so we raise it when analyzing our results.<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a>In response to the questions raised. We have not analyzed the degree of induced diabetes after distal pancreatectomy. Our study assesses short-term outcomes. We consider your comment and keep it in mind for future analysis.Regarding the perception and satisfaction of the patients, as well as the functional recovery. This analysis is a departure from the main objectives of the study, and would in itself deserve to be presented in a single article. Nevertheless, we consider it elementary and have already incorporated it into the set of variables to be analyzed in daily clinical practice.We have carefully reviewed the articles referenced in your letter. We have not found a clear justification in both studies as they have not used a learning curve analysis methodology and both have some biases in this respect.We believe, and this has been our experience, that the robotic platform shortens the learning curves. As Müller et al. reported, the analysis of learning curves in literature is arbitrary in some cases.<a class="elsevierStyleCrossRef" href="#bib0015">3</a>In the last years, new literature has become available, and robotic pancreatic surgery had a significant expansion. Recently, the internationally validated European guidelines on minimally Invasive Pancreatic Surgery proclaimed that the learning curves for robotic distal pancreatectomy are slightly shorter compared with a laparoscopic approach. Apart from, minimum center volumes and indications for minimally invasive surgery were the most debated topics.<a class="elsevierStyleCrossRef" href="#bib0020">4</a>Again, we would like to thank you for your suggestions." 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Vol. 102. Issue 4.

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