Minimally invasive surgical approaches

Minimally invasive surgery techniques have remarkably evolved over the past few decades in the field of surgical oncology, including for pancreatic malignancies. Although experience is still in its nascence, the emergence of the robotic surgery platform has accelerated widespread implementation of minimally invasive pancreatectomy. Improved short-term outcomes can accelerate the return to intended oncologic treatment and may result in improved oncologic outcomes of pancreatic malignancies. However, whether minimally invasive approaches can maintain the quality of oncologic surgical procedures, as well as the generalizability of minimally invasive oncologic surgery outside of a few expert surgeons, remains unknown. No prospective studies have been conducted to investigate the oncologic outcomes of minimally invasive pancreatectomy for pancreatic ductal adenocarcinoma, and continued critical evaluation is warranted. Minimally invasive pancreatectomy programs must be implemented with thoughtful strategic planning to ensure safety, and all effort should be made to shorten the learning curve for surgeons.