Minimally Invasive Surgery for Pancreatic Cancer

Minimally invasive pancreatic surgery (MIPS) was first described in the 1990s as laparoscopic pancreatoduodenectomy and, a little later, as laparoscopic distal pancreatectomy. Then, at the beginning of the new millennium, the robot-assisted approach made it possible to overcome some of the limitations of laparoscopy. Minimally invasive pancreatic surgery should allow the same oncologic and clinical outcomes as open pancreatic surgery, with some advantages regarding surgical incision, postoperative pain, and postoperative recovery. Initially, MIPS was applied for benign diseases and low-grade malignant pancreatic neoplasms, while instead, in recent years, the indication for laparoscopic and robot-assisted approaches has been extended to pancreatic cancer, even with associated vascular resection and reconstruction. This chapter details the indications, operative techniques, postoperative outcomes, and personal experience.