Background : The indications and evidence based for robotic pancreaticoduodenectomy (RPD) have increased dramatically over the past two decades, and RPD is now considered a safe and oncologic equivalent surgical option for patients with periampullary cancer. This study aims to show the single surgeon experience of 30 cases after the introduction of RPD and to report changes in surgical outcomes and standardization of surgical techniques.

Methods : From Jan 2023 to Jan 2024, 30 patients who underwent RPD for periampullary neoplasms were enrolled. Clinicopathological characteristics and perioperative outcomes were examined and compared with the existing literature, serving as a benchmark for evaluation. Furthermore, an in-depth analysis of the procedural durations was conducted, allowing for an assessment of RPD proficiency in relation to surgical experience

Results : The mean operative time was 360 (260-573) mins, and the median intraoperative blood loss was 270 (50-800) ml. Postoperative complications occurred in 9 (30%) of patients, with no requiring reoperation. The mean length of hospital stay was 11 (5-29) days, and there were no instances of 30-day mortality. When comparing the operative outcomes with these studies, our results of RPD were comparable. Total operation time has dramatically decreased after 25 cases of RPD. Especially, the time for anastomosis have gradually decreased.

Conclusions : This single-surgeon experience suggests that RPD can be a valuable additional option of surgical techniques for PD and warrants further investigation in larger cohorts and comparative studies.