Minimally invasive hepatobiliary and pancreatic surgery

The learning curve associated with the adoption of innovation in surgical practice creates tension between the potential benefits of technological advances and the duty to protect patients from avoidable harm. Fear of learning curve‐associated excess patient morbidity might be a key factor in the delayed adoption of Minimally Invasive HepatoBiliary and Pancreatic (MI-HPB) surgery. This PhD thesis incorporates several studies focused on the safe and effective adoption of MI-HPB surgery. The first study describes the safe and effective implementation of robot-assisted distal pancreatectomy trough a procedure specific, mastery‐based training program. Eye tracking is implicated as a tool to differentiate levels of experience with MI-HPB surgery in the following chapter. The second part of this thesis focusses on the impact of surgical innovation on non-technical skills. New technology increases non-technical demands of surgical teams. Tasks and competences of surgical teams need to evolve with adoption of new technology and innovation to maintain efficiency and safety during surgery. Lastly, the efficacy and safety of robot-assisted median arcuate ligament release and robot-assisted surgery for benign duodenal tumors is implicated.