Robotic Spleen-Preserving Distal Pancreatectomy: Perioperative Outcomes and Comparison of Two Energy Devices.

BACKGROUND

We evaluated the perioperative outcomes of robotic spleen-preserving distal pancreatectomy (RSPDP) and compared articulated monopolar curved scissors (R-MCS) with the harmonic scalpel (R-HS) as the primary energy device.

METHODS

We retrospectively reviewed consecutive single-centre RSPDPs (September 2020-August 2025) and compared baseline characteristics, intraoperative variables, and postoperative outcomes.

RESULTS

Sixty-nine patients were included (R-MCS, n = 31; R-HS, n = 38). Overall spleen preservation was 79.7%, with no between-group difference (80.6% vs. 78.9%, p = 0.852). Among spleen-preserved cases, Kimura completion was higher with R-MCS (88.0% vs. 66.7%, p = 0.032). Operative time and blood loss were comparable. Time to first flatus was shorter with R-MCS (3.2 ± 0.9 vs. 3.7 ± 0.7 days, p = 0.014). Overall complications occurred in 18.8%, including clinically relevant postoperative pancreatic fistula in 11.6%; no Clavien-Dindo grade ≥ IIIb complications or perioperative mortality occurred.

CONCLUSION

RSPDP is safe and feasible. R-MCS may improve Kimura completion and modestly shorten the time to first flatus, pending further validation.