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Donisi et al. Mini-invasive Surg 2021;5:38 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.55

Editorial Open Access

What role does hand-assistance have in minimally

invasive pancreatic surgery?

1,2
Greta Donisi , Alessandro Zerbi 1,2
1
Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, Milan 20089, Italy.
2
Department of Biomedical Sciences, Humanitas University, Milan 20090, Italy.
Correspondence to: Dr. Greta Donisi, Pancreatic Surgery Unit, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano,
Milan 20089, Italy. E-mail: Greta.donisi@humanitas.it

How to cite this article: Donisi G, Zerbi A. What role does hand-assistance have in minimally invasive pancreatic surgery? Mini-
invasive Surg 2021;5:38. https://dx.doi.org/10.20517/2574-1225.2021.55

Received: 25 Apr 2021 First Decision: 4 Jun 2021 Revised: 11 Jun 2021 Accepted: 27 Jul 2021 First online: 3 Aug 2021

Academic Editors: Andrew A. Gumbs, Kit Fai LEE, Giulio Belli Copy Editor: Yue-Yue Zhang Production Editor: Yue-Yue Zhang

MINIMALLY INVASIVE SURGERY: RATIONALE, ADVANTAGES AND LIMITATIONS
Surgery poses an important stress on the patient from both physical and psychological points of view per se.
It has become clearer with time that, regardless of the type of surgical operation, a smaller surgical incision
could reduce the operation-induced stress. With advancements in technology, great efforts have been made
in trying to reduce this burden on the patient, leading to the development of minimally invasive surgery
(MIS) . MIS has gained increasing support since its introduction and has undergone continuous
[1,2]
improvements and evolutions to the point of becoming, nowadays, the standard of care for many surgical
procedures such as cholecystectomy, adrenalectomy, splenectomy, and fundoplication. MIS encompasses
several different approaches which have in common the aim of decreasing the impact of the surgical
operation on the patient. The first approach to be developed and widely accepted in clinical practice was
laparoscopy. Among the well-established advantages of laparoscopic surgery, we have decreased pain,
shorter length of stay, faster postoperative recovery, and a better visualization of secluded anatomical spaces
which would otherwise require a large incision to be correctly exposed . All of this comes at the price of
[3]
decreased dexterity, diminished tactile feedback, and inherent limitations posed by restricted degrees of
freedom of laparoscopic instrumentation, which may result in a longer operative time compared to the open
[4]
approach for complex surgical procedures . In recent years, an alternative to the laparoscopic technique has
been proposed with the introduction of robotic platforms in surgery. Potential advantages of robotic surgery
are filtration of tremors, better dexterity, higher degrees of freedom with the EndoWrist system, and better

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
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adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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indicate if changes were made.

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