The development of minimally invasive robotic surgery has always been the focus of the discipline. Pancreaticoduodenectomy has been regarded as the "Mount Everest" of surgical operations because of its high risk and mounting difficulty. Standardized surgical steps and easy-to-follow operation techniques are helpful to promote the application of robotic pancreaticoduodenectomy (RPD). Therefore, in this paper, we summarize the RPD to form an 18-step surgery procedure and analyze the key points of circumferential vessel resection and reconstructive anastomosis techniques, based on the experience of RPD at the First Medical Center of Chinese People's Liberation Army General Hospital, with the hope of promoting the in-depth application of robotics in pancreatic surgery and furthering the establishment of RPD application standards.

Robotic system has overcome the limitations of traditional laparoscopy and promoted the development of minimally invasive surgery. However, in the early stage of robotic hepatopancreatobiliary surgery, the lack of resection and reconstruction technology compatible with the robotic system restricts its application. Based on the previous experience, we propose the circumvascular resection technique, which takes the main blood vessels as the mark, mobilizes the blood vessels and excises the soft tissues around the blood vessels, and the double-low reconstruction technique, which can improve the reconstruction quality by reducing the tissue tension and the tensile stress per unit area during the reconstruction. These two techniques can address the limitations of the robotic system including limit operating space and lack of force feedback, and help to improve surgical safety, reduce learning curve and promote the clinical application of robotic hepatopancreatobiliary surgery.