Minimally invasive pancreatic surgery: An upward spiral

Minimally invasive techniques have been widely applied in general surgery for decades, but the generalization in pancreatic resection underwent a hard process for the complexity of the procedure. The current studies suggested that the safety and feasibility of minimally invasive pancreatic surgery (MIPS) were approximately equivalent to that of open surgery, but the overall benefit and the oncological outcomes of MIPS remained to be verified. Inferior outcomes were observed in the initial learning curve phase and low-volume hospitals, thus establishing a program that can well assess the learning process and minimize the harm to patients was essential. To ensure safety, the patients should be strictly selected in the early phase of the learning curve, and a careful and judicious stepwise should be considered to broaden the indications.