93 Robotic Distal Pancreatectomy: Our Experience with the Versius Robotic Surgical System

Abstract Introduction Distal pancreatectomy (DP) is a well-established minimally invasive procedure. However, the feasibility and technical nuances of utilizing the Versius robotic surgical system remain underexplored Aim To share our experience with the versius robot Method A retrospective analysis was conducted on all consecutive robotic distal pancreatectomies (RDP) performed at the Manchester Royal Infirmary. These included both distal pancreatectomy with splenectomy (DPS) and spleen-preserving distal pancreatectomy (SPDP). Preoperative, intraoperative, and postoperative details were prospectively collected and analysed. The study received ethics committee approval, ensuring compliance with ethical standards. Results Between May 2021 and January 2025, a total of 15 RDPs were performed, comprising 11 DPS and 4 SPDP. Procedures were primarily conducted by two hepato-pancreato-biliary surgeons, employing four robotic arms and one assistant port (Figure 1). The instrumentation predominantly included two graspers, a monopolar hook, and bipolar forceps. Conversion to open surgery occurred in one case. The mean operating time was 217 minutes (range: 118–320 minutes), with an average robot docking time of 8.1 minutes (range: 3–15 minutes). Complications were observed in 4 cases (27%), including clinically relevant postoperative pancreatic fistula (POPF) in 4 patients (27%). 1 patient was reoperated for bleeding, and no 90-day mortality was recorded. Conclusions The use of the Versius robotic surgical system for RDP is both safe and feasible, with early cases requiring careful patient selection. The system presents distinct advantages and disadvantages, which merit further investigation.