With the growing complexity and costs of modern surgical practice, convincing and unbiased quality assessment becomes mandatory. The notion of quality assessment is widely recognized and used in the world of business and manufacturing. A possible tool of quality assessment is benchmarking. Benchmarking is a process of measuring performance in order to enable for outcome comparison and improvement within a specific domain. In the surgical community, however, such standard outcome measures and multicenter comparison of results have been poorly developed and benchmarking for the best possible results for specific procedures is lacking.

The first landmark study defining benchmark outcomes for liver resection was presented at the 2016 ASA meeting in Chicago and published in Ann Surg (Rössler et al., Ann Surg, 2016). More recently benchmark values were established for liver transplantation (Muller et al., Ann Surg, 2018), esophagectomy (Schmidt et al., Ann Surg, 2017), pancreas surgery (Sánchez-Velázquez et al., Ann Surg, 2019), bariatric surgery (Gero et al., Ann Surg, 2019) and ALPPS (Raptis et al., Ann Surg, 2019).

Robotic pancreatoduodenectomy (RPD) is increasingly performed mainly for patients with resectable pancreatic cancer or other diseases of the pancreatic head requiring resection.  Current randomized trials are seeking to compare outcomes with open surgery but evidence on settings that benefit patient groups is still unclear. Benchmark criteria for RPD will aid in the decision making and scientific evolution to produce high quality evidence with relevant endpoints in pancreatic surgery.

To identify the best possible outcome (i.e. benchmarking), data from high-volume centers in low risk patients will be analyzed. These benchmark outcomes will serve as “controls” for comparison with any future analyses of RPD. This study aims to define clinically relevant benchmark outcome values for RPD in a low-risk patient population treated in high-volume centers on 3 continents.