Navigating the Intricacies of Robotic Pylorus-Preserving Pancreaticoduodenectomy Using the da Vinci SP (Single Port) System

<b>Background:</b> Robot-assisted pylorus-preserving pancreaticoduodenectomy (RPPPD) has been increasingly adopted, leveraging the advantages of robotic technology. RPPPD is rarely performed using the da Vinci SP system. In this study, we address the technical issues encountered during the early experiences with robotic pylorus-preserving pancreaticoduodenectomy (RPPPD) using the da SP Vinci system and propose effective solutions. <b>Method:</b> We retrospectively analyzed the outcomes of seven patients who underwent RPPPD using the da Vinci SP system. The primary technical challenges included limited instrument maneuverability, difficulty in maintaining clear surgical views, and the need for precise anastomosis. <b>Results:</b> Postoperatively, all patients were discharged without significant complications, with no clinically relevant pancreatic fistulas observed. Only minimal scarring was observed postoperatively. In addition, our results showed that operative time gradually decreased. The operation time was significantly shorter in the RPPPD using the SP system group compared to the RPPPD using the multiport system group. <b>Conclusions:</b> Implementing enhanced preoperative planning, advanced intraoperative imaging, and specialized robotic tools can significantly improve surgical efficiency and patient outcomes.