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Page 8 of 10 Kauffmann et al. Mini-invasive Surg 2020;4:54 I http://dx.doi.org/10.20517/2574-1225.2020.46

was decided based on the thickness of the pancreatic parenchyma. In most patients a purple cartridge
reinforced with a bioabsorbable line reinforcement.

Robotic assistance allows to do this as easily as in open surgery, especially when the pancreatic body is
partially spared and the pancreas is not divided at the neck, where the stapler should be ideally applied
to achieve the best results. While in malignant tumors there is no good reason to spare a portion of the
pancreatic body, in benign or pre-malignant tumors parenchymal sparing distal pancreatectomy can be
conveniently adopted to reduce the metabolic and digestive consequences of partial pancreatectomy. The
literature shows that incidence and severity of POPF are similar irrespective of which surgical technique
[40]
is used . Therefore, it is not surprising that robotic assistance does not reduce the occurrence of this
complication.

In conclusion, robotic assistance, although not essential, is important to maximize the probability of spleen
preservation along with the splenic vessels. RA-SPDP is also associated with a low conversion rate and a
limited incidence of severe post-operative complications.

DECLARATIONS
Authors’ contributions
Conception and design: Kauffmann EF, Boggi U
Provision of study materials or patients: Kauffmann EF, Napoli N, Menonna F, Genovese V, Cacace C,
Gianfaldoni C, Vistoli F, Boggi U
Collection and assembly of data: Kauffmann EF, Napoli N, Menonna F, Genovese V, Cacace C, Gianfaldoni
C, Vistoli F, Amorese G, Boggi U
Data analysis and interpretation: Kauffmann EF, Menonna F, Boggi U
Manuscript writing: Kauffmann EF, Napoli N, Menonna F, Genovese V, Cacace C, Vistoli F, Amorese G,
Boggi U
Final approval of manuscript: Kauffmann EF, Napoli N, Menonna F, Genovese V, Cacace C, Gianfaldoni C,
Vistoli F, Amorese G, Boggi U

Availability of data and materials
Data are stored in a database at University of Pisa.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
The study was approved by the local ethic committee.

Consent for publication
The informed consent of the person in the video was obtained.

Copyright
© The Author(s) 2020.

REFERENCES
1. Asbun HJ, Moekotte AL, Vissers FL, Kunzler F, Cipriani F, et al. The miami international evidence-based guidelines on minimally