Highlights from the article: Patient-specific factors such as age, co-morbidities, body mass index (BMI), and multiple previous abdominal procedures play an important role and must be considered when evaluating patients for a robotic PD. Larger, thicker ducts such as patients who have had metal biliary stents placed or chronic biliary obstruction are reconstructed using running sutures, including a 4-0 monofilament, barbed, absorbable suture (V-loc suture, Medtronic) (Fig. 15). A large, multi-center study compared the outcomes of 211 patients from two high-volume robotic PD centers and 817 patients from six high-volume open PD centers.[9] Median operative times were approximately 75 min more with the robotic approach although the estimated blood loss was 181 mL lower on average. Patients undergoing a robotic-assisted PD had a postoperative pancreatic fistula rate of 6.6% compared to the 11.2% fistula rate for patients undergoing an open PD.