Summarize and analyze the application value and experience of intraoperative ultrasound (IOUS) in robot-assisted pancreatic benign - low malignant tumor surgery.

A retrospective analysis was performed on the clinical and IOUS data of IOUS assisted robotic pancreatic tumor surgery patients who were diagnosed as benign and low-grade pancreatic cancer before surgery and performed in Department of Hepatobiliary and pancreatic Surgery, PLA General Hospital from Oct. 2019 to Oct. 2021.

In 147 patients, IOUS could find and locate all tumors, 130 patients (88.4%) could identify the relationship between tumor and main pancreatic duct, and 23 patients’ (15.6%) surgical planning were changed under the guidance of IOUS. The mean operation time was (183.3±75.1) min, the median postoperative hospital stay was 7 days, 22 patients (15.0%) had B level pancreatic fistula or above, 15 patients (10.2%) had Clavien-Dindo grade Ⅲ or above serious complications, and there was no 90-day death.

IOUS can locate tumor location intraoperatively, pinpoint the relationship between tumor and bile duct and main pancreatic duct, find hidden lesions missed by preoperative imaging, determine the position and the continuity of the main pancreatic duct and determine the position of supporting duct after tumor resection, which is beneficial to appropriate surgical decisions making and less postoperative complications. The application of IOUS support the safe and smooth implementation of robot-assisted surgery for pancreatic benign and low-grade tumors.