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Background <p>Postoperative pancreatic fistula (POPF) is a serious complication after pancreaticoduodenectomy (PD). We present a standardized and reproducible technique (IDEAL stage 2a) to perform a&#xa0;robotic modified Blumgart anastomosis with self-locking barbed wires.</p> Methods <p>Between October 2023 and March 2025, 22 patients underwent a&#xa0;robotic&#xa0;pancreaticoduodenectomy with a modified Blumgart anastomosis median&#xa0;pancreatic duct diameter measured 3&#xa0;mm. Fifteen patients had&#xa0;a soft pancreas (68%). Sixteen patients (73%) had a&#xa0;high risk for POPF (ua-FRS ≥ 20%).</p> Results <p>Severe postoperative complications (Clavien–Dindo grade ≥ 3) were observed in two patients (9%). There was no clinically relevant postoperative pancreatic fistula (cPOPF). Median blood loss was 40&#xa0;cc (IQR 123&#xa0;cc) and median operative time was 300&#xa0;min (IQR 48&#xa0;min). Median length of hospital stay after surgery was 12&#xa0;days (IQR 7&#xa0;days).</p> Conclusion <p>Our initial experience suggests that a&#xa0;robotic modified Blumgart anastomosis with self-locking barbed wires is safe and reproducible.</p> Graphical abstract <p></p>

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Robotic pancreaticoduodenectomy with modified Blumgart anastomosis with self-locking barbed wires: technical aspects and initial results

  • 期刊论文

  • 发表日期：

    2025年11月20日

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  • Bram Vanhoof,
  • Edward Willems,
  • Ismaël Chaoui,
  • Tom Vandaele,
  • Celine De Meyere,
  • Kenzo Mestdagh,
  • Mathieu D’Hondt

摘要

Background

Postoperative pancreatic fistula (POPF) is a serious complication after pancreaticoduodenectomy (PD). We present a standardized and reproducible technique (IDEAL stage 2a) to perform a robotic modified Blumgart anastomosis with self-locking barbed wires.

Methods

Between October 2023 and March 2025, 22 patients underwent a robotic pancreaticoduodenectomy with a modified Blumgart anastomosis median pancreatic duct diameter measured 3 mm. Fifteen patients had a soft pancreas (68%). Sixteen patients (73%) had a high risk for POPF (ua-FRS ≥ 20%).

Results

Severe postoperative complications (Clavien–Dindo grade ≥ 3) were observed in two patients (9%). There was no clinically relevant postoperative pancreatic fistula (cPOPF). Median blood loss was 40 cc (IQR 123 cc) and median operative time was 300 min (IQR 48 min). Median length of hospital stay after surgery was 12 days (IQR 7 days).

Conclusion

Our initial experience suggests that a robotic modified Blumgart anastomosis with self-locking barbed wires is safe and reproducible.

Graphical abstract