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Shannon et al. Mini-invasive Surg 2023;7:32 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2023.83

Review Open Access

A narrative review of the history and recent

advances in minimally invasive pancreatic resection

Alexander Shannon, Natalie M. Bath, Aslam Ejaz
Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210,
USA.

Correspondence to: Dr. Aslam Ejaz, Division of Surgical Oncology, Department of Surgery, The Ohio State University Wexner
Medical Center, 395 W 12th Avenue, Columbus, OH 43210, USA. E-mail: aslam.ejaz@osumc.edu

How to cite this article: Shannon A, Bath NM, Ejaz A. A narrative review of the history and recent advances in minimally invasive
pancreatic resection. Mini-invasive Surg 2023;7:32. https://dx.doi.org/10.20517/2574-1225.2023.83

Received: 12 Jul 2023 First Decision: 22 Aug 2023 Revised: 1 Sep 2023 Accepted: 11 Sep 2023 Published: 19 Sep 2023

Academic Editor: Giulio Belli Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Pancreatic resections are complex operations that carry the potential for long-term and life-threatening
complications. Over the past several decades, improved surgical techniques and perioperative care have decreased
the morbidity and mortality associated with these operations. As laparoscopic and robotic-assisted surgery has
been increasingly used in other specialties, the role of minimally invasive techniques in pancreatic surgery remains
unclear. We aimed to review the evolution of pancreatic surgery and summarize current data comparing outcomes
between open and minimally invasive pancreatic techniques. A comprehensive review was performed using
MEDLINE/PubMed with the search dates of January 1, 2018 to February 28, 2023. In PubMed, the terms
“pancreas”, “minimally invasive surgery”, and “robotic surgery” were searched. Minimally invasive distal
pancreatectomy (DP) is associated with decreased length of hospital stay and intraoperative blood loss with
similar morbidity and mortality when compared to open DP. While randomized data supports decreased length of
stay for minimally invasive pancreaticoduodenectomy (PD), the LEOPARD 2 trial was terminated early due to
increased mortality among patients undergoing laparoscopic PD. Minimally invasive DP appears safe and
efficacious compared to open surgery, whereas additional ongoing randomized studies from experienced centers
are needed to determine the role of minimally invasive surgery for PD.

Keywords: Pancreas, minimally invasive surgery, robotic surgery, open surgery

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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