Our study is a retrospective analysis of the first 30 patients undergoing completed robotic-assisted pancreatic resection and reconstruction at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, between October 3, 2008, and February 26, 2010. Study procedures were approved by the University of Pittsburgh Institutional Review Board. We identified 3 types of pancreatic reconstruction: non-pylorus-preserving robotic-assisted pancreaticoduodenectomy (RAPD), robotic-assisted central pancreatectomy (RACP) for nonmalignant lesions of the pancreatic neck and body, and the Frey procedure for chronic pancreatitis. Whereas laparoscopic mobilization and dissection were used with varying frequency during the resection phase, division of the pancreas, resection of the uncinate process, and reconstruction of all anastomoses were performed robotically. The pancreas was divided with hook electrocautery after the placement of 2-0 silk suture ligatures at the superior and inferior borders to assure hemostasis. Vascular control during the uncinate resection was accomplished with a combination of suture ligatures, hemoclips, and LigaSure (Covidien, Boulder, Colorado) as necessary. In RACP, the proximal pancreatic transection was performed with an endoscopic stapler reinforced by absorbable mesh (Seamguard; W. L. Gore and Associates, Inc, Flagstaff, Arizona). Intravenous secretin (0.15 μg/kg) was used selectively to identify microscopic pancreatic ducts when visual inspection alone was insufficient. Pancreatic duct reconstruction following RAPD and RACP was performed with a modified Blumgart technique15 in every case. The anastomosis consisted of interrupted horizontal mattress sutures of 2-0 silk between the pancreatic parenchyma and the seromuscular layer of the jejunum. The duct-to-mucosa anastomosis was created with interrupted 5-0 polydioxanone sutures. Pancreatic duct stents (5F or 7F Zimmon stents; Cook Medical Inc, Bloomington, Indiana) were inserted routinely to assure duct patency. Reconstruction following the Frey procedure was performed with running 4-0 polydioxanone suture. Two closed suction drains were placed anterior and posterior to the pancreatic anastomosis in every case. Amylase levels were checked after the reinstitution of oral intake in all patients prior to drain removal.