Robotic hepatobiliary and pancreatic surgery using the chinese domestic robotic platforms: a multicenter retrospective cohort study on prospectively collected data

Background: There is a dearth of assessments of short-term outcomes of hepatobiliary and pancreatic surgery using the Chinese domestic robotic platforms. The aim of this study is to evaluate the safety and feasibility of various hepatobiliary and pancreatic surgeries using the domestic robotic platforms. Methods: In the multicenter retrospective cohort study of prospectively collected data, the demographics and short-term outcomes of patients underwent hepatobiliary and pancreatic surgery using the domestic robotic platforms were collected and analyzed. Patients were prospectively enrolled from January 2024 to February 2025, and followed up for 90 days postoperatively. The Toumai robotic surgical platform (MicroPort®MedBot™ Group Company, Shanghai, China) and MP series robotic platform (Edge Medical Company, Shenzhen, China) were introduced to perform all procedures. Patients with resectable hepatobiliary and pancreatic tumor were considered to meet surgical criteria for robotic procedures. Results: Eighty-seven patients underwent surgeries using the domestic robotic platforms. Herein, 14 patients underwent robotic pancreaticoduodenectomy (RPD), one underwent remote RPD (R-RPD), nine underwent robotic distal pancreatectomy (RDP), 11 underwent robotic enucleation of pancreatic lesions (REN), one underwent robotic central pancreatectomy (RCP), one underwent robotic duodenum-preserving pancreatic head resection (RDPPHR), 45 underwent robotic hepatectomy (RH), and five underwent robotic radical resection for hilar cholangiocarcinoma (R-HCCA). A total of nine patients had clinically related postoperative pancreatic fistula (CR-POPF) grade B. One patient in each of the RPD (7.14%), REN (9.1%) and RH (2.2%) subgroups underwent conversion to open surgery because of intraoperative hemorrhage. Physiological stability was maintained during the procedure. All procedures achieved R0 resection. None of the patients required readmission to the hospital, and no 90-day mortality was observed. Pathological examination showed 13 malignant tumors in RPD group, one in R-RPD group, 22 in RH group, and five in R-HCCA group respectively. Conclusion: Robotic hepatobiliary and pancreatic surgery using the domestic robotic platforms in selected patients is technically safe and feasible. The domestic robotic platforms are an alternative option with considerable outcomes. Further verification and more operative experience are needed to optimize its application.