Huang, 68, visited a local hospital in Zhejiang province a month ago for upper abdominal pain and progressive yellowing of the skin. The doctor said he suspected a pancreatic tumor and suggested going to Shanghai for surgery. Hearing that the pancreatic surgery of Ruijin Hospital is nationally famous, the family accompanied Huang to come here. After being admitted to the hospital, a multidisciplinary consultation on pancreatic diseases (MDT) was conducted, and the diagnosis of malignant tumor in the head of the pancreas with local lymph node metastasis was confirmed. Considering the patient’s age and high surgical risk, and in order to avoid the huge trauma caused by traditional open surgery, the experts decided to perform robotic pancreaticoduodenectomy for him. Pancreaticoduodenectomy is recognized as one of the most complicated and difficult surgeries, because the head of the pancreas is in the central area of the abdominal cavity, closely connected with several important organs and next to important blood vessels such as the abdominal aorta and inferior vena cava. Once the head of the pancreas is diseased, the connected duodenum, gallbladder, common bile duct and stomach need to be removed, and three anastomoses of pancreatic jejunum, bile duct jejunum and gastric jejunum need to be performed at the same time. Such a difficult surgery requires a high level of skill for the surgeon in charge, but Professor Peng Chenghong has long been familiar with pancreatic tumor resection, and he leads his team to perform more than 400 pancreatic surgeries every year. So far, nearly 400 robotic pancreatic surgeries have been performed, the highest in China and the second in the world, and good clinical results have been achieved. At 10 o’clock in the morning of April 15, everything was ready, and Professor Peng Chenghong entered the operating room and the operation started officially. He was experienced in removing the specimen and clearing the lymph nodes step by step. In less than two hours, he and his surgical team removed the tumor completely and took out the specimen from a small incision of about 4 cm in the lower abdomen and put it into a specimen bag, which heralded the end of the first half of the surgery. Afterwards, the machine was re-installed and Director Peng started the second half of the surgery, i.e. the reconstruction of the digestive tract (three major anastomoses of pancreatic-intestinal, biliary-intestinal and gastrointestinal). The whole operation went smoothly, taking only 4 hours and bleeding less than 50 ml. As the patient was taken out of the operating room, it marked the successful completion of the 100th da Vinci pancreaticoduodenectomy in Ruijin Hospital. Due to the large incision, bleeding and long wound exposure time in traditional pancreatic surgery, the patient’s recovery is slow. In contrast, robotic surgery can do more precise cutting and suturing operations through a three-dimensional imaging system with 10 times magnification, reducing intraoperative bleeding and greatly reducing trauma to the patient. The recovery after robotic surgery is significantly faster, and there is no significant difference in the incidence of postoperative complications and other aspects. At present, Lao Huang has basically healed and is ready to be discharged from the hospital.