Update on laparoscopic pancreatectomy in 2010.

Minimally invasive surgery has been proven to be a safe and effective method of surgically managing several gastrointestinal conditions. In the last ten years, increased expertise in laparoscopic surgery and the availability of new surgical devices have contributed to the development of laparoscopic pancreatic surgery. Currently, distal pancreatectomies for benign/low-grade malignant tumors represent the majority of pancreatic resections performed laparoscopically. They are characterized by improved postoperative short-term outcomes compared to open surgery. Pancreaticoduodenectomy still represents a formidable technical challenge for laparoscopy. However, laparoscopic pancreaticoduodenectomy has been proven to be safe and feasible with outcomes comparable to those of open surgery if performed at experienced centers. Robotic surgery, recently introduced in the field of minimally invasive surgery, improves the view and the maneuverability of the instruments compared to standard laparoscopic surgery. The feasibility and safety of robotic pancreatectomy have been recently reported for complex pancreatic resection. This approach has the potential to bridge the gap between minimally invasive surgery and complex pancreatic surgery, allowing the indications for minimally invasive pancreatic surgery to be extended. Almost 15 years after its description, laparoscopic pancreatic surgery is seeing an exponential growth in its applications. The growing experience in laparoscopy and the introduction of robotics will further expand the field of minimally invasive pancreatic surgery in the next several years.