https://www.selleckchem.com/products/a-1331852.html Data collected from July 2017 till October 2018 were analysed retrospectively with regard to conversion rate, morbidity (Clavien Dindo > 2) and 90-d-mortality. Results The first step of establishing our robotic surgical program included 26 procedures. Here, conversion rate, morbidity and mortality were 0%. In the second step of implementation, 23 procedures were performed. Conversion rate, morbidity and mortality were 28, 8 and 0% respectively. The last step included 51 advanced and highly complex procedures. These procedures had a morbidity of 41%, a mortality of 4% and a conversion rate of 43%. Conclusion Our stepwise approach enables safe implementation of a robotic surgical program for upper GI and HPB surgery with comparable morbidity and mortality even for highly complex procedures. However, highly complex procedures in the learning curve required a high conversion rate.The development and proliferation of robot-assisted surgery has greatly extended the field of minimally invasive surgery. Thus, this necessitates the development of adequate training programs to prepare surgeons for the operating room of the future. Transferring established and proven methods of training and assessment in aviation could help robotic training programs become more effective, efficient and safer. Simulation is a safe and cost-effective way of training and in addition may improve operating room performance. Proctoring and flying doctor models are established concepts, especially for advanced training. This review summarises current developments in robotic surgical training and teaching and may help to start a controversial discussion.Introduction The use of robots in minimally invasive surgery has become increasingly common in recent years. Robot-assisted pancreatoduodenectomy is more frequent than the laparoscopic procedure especially due to the greater flexibility of instruments and therefore better handling and better angulatio