Sanjay Pandanaboyana¹, Ziqian Zhou²

¹HPB and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, United Kingdom; ²HBSN Editorial Office, AME Publishing Company.

Editor’s note

The 11th Joint Conference of the University of Chicago and PUMCH Liver Surgery was successfully held in Beijing, China, from September 5 to 6, 2025. This year’s conference focused on Liver Transplantation, Cell Therapy, Robotic Surgery, Artificial Intelligence (AI), and the Comprehensive Treatment of Liver Cancer.

Taking this opportunity, we conducted an interview with Prof. Sanjay Pandanaboyana from the HPB and Transplant Unit, Freeman Hospital, Newcastle upon Tyne, United Kingdom.

Expert’s introduction

Prof. Sanjay Pandanaboyana is a consultant HPB surgeon at the Freeman hospital in Newcastle upon Tyne.

He underwent his higher surgical training in the Scotland followed by HPB fellowships in Auckland, Edinburgh and Leeds. His clinical areas of interests are pancreatic cancer and acute pancreatitis. Prof. Pandanaboyana has a strong research portfolio with 200 publications and currently hold a position of  professor of HPB Surgery, Newcastle University. He has a particular interest in systematic reviews and meta-analysis with more than 100 systematic reviews published on topics related to HPB Surgery.

Prof. Pandanaboyana also holds the current positions in National and International organisations:

Chair: Surgical Specialist Board| Royal College of Surgeons of Edinburgh
Committee member: Pancreas Clinical Research Group| British Society of Gastroenterology (BSG)
Research chair: Pancreatic Society of Great Britain and Ireland (PSGBI)
Guidelines and Quality of Care committee member: European Pancreas Club (EPC)
Scientific and Research Committee member: European Hepatopancreatobiliary association (EAHPBA)
Member International Study Group on Pancreatic Surgery (ISGPS)

Interview

HBSN: What do you think are the key factors in selecting appropriate cases for robotic surgery training, particularly in HPB surgery?

Prof. Pandanaboyana: I think over the last 10 years or so, more and more hospitals, both in Europe, Asia and America, have acquired robotic platforms to undertake more robotic surgery. And because most of these centers have started  performing cases in the last few years, case selection is the most important aspect to make sure we don't harm the patient in any way. And there is enough data accumulating now that we should follow a step-wise approach in terms of case selection and undertake robotic surgery with adequate mentoring. That's what we do in the UK. We follow a step-wise approach and break down case selection from easier cases to start with. For instance, if you're doing pancreatic resections, try and choose easier cases like high risk IPMNs, Neuroendocrine tumours and other cystic neoplasms of the pancreas. Once you go past the learning curve i.e past the competency phase then you can move on to the proficiency phase, then you choose much more complex cases like cancers. So, I think there should be a scope for a step-wise approach to selecting cases appropriately as you progress through the learning curve in robotic surgery training, so that you can achieve good outcomes while also not compromising patient safety.

HBSN: In your view, is the primary driver for research on robotic distal pancreatectomy technological innovation or clinical necessity?

Prof. Pandanaboyana: I think it's a combination of both — technological innovation and clinical necessity. For instance, the evidence published so far for robotic left pancreatic technique suggests that, with the use of robot, a high number of patients can have splenic preservation. So, in a way,  we are seeing improved clinical outcomes. There is reduced blood loss with robotic platforms. So, there is a clinical necessity to improve clinical outcomes, and that could be achieved by using robotic platforms. And also, by using robotic platforms more and more, there will be improvement in technology as well. For instance, we have heard from a lot of speakers today about how we can incorporate artificial intelligence into robotic platforms and can assist us in terms of identifying complex steps during surgery. And it also reduces the morbidity, both intraoperatively and hopefully improves outcomes for the patients in the postoperative setting. So, I think both technological innovation and clinical necessity should go hand in hand, so we can achieve good outcomes for the patients.

HBSN: What role do you think AI will play in the future of HPB surgery?

Prof. Pandanaboyana: That's quite a complex question because HPB surgery is so broad and my area of expertise is predominantly pancreas. And what we have again heard from various speakers today is, particularly for the pancreas. The major risk during a Whipple procedure is intraoperative bleeding. And we have heard again and seen from some of the videos today that if AI can predict the risk of bleeding and the risk of developing postoperative complications — either intraoperatively or at the end of the operation — then we can optimize patient management  on an individual basis. So, what we are talking about is not overall management of a group of patients. What we are talking about is precision medicine.

So, we focus treatment and targeted treatment for individual patients rather than for a group of patients. And that's where AI will have a role to play — not just with intraoperative management but also with preoperative risk prediction, intraoperative risk reduction, and also postoperative management by predicting risks. By doing this, we can focus a bit more on that patient and identify risk reduction strategies, which could be implemented at the end of the operation.

HBSN: What inspired you to pursue a career as a surgeon?

Prof. Pandanaboyana:  I've always been fascinated by surgery. I had amazing mentors at the start of my surgical career who supported me and inspired me to take up HPB Surgery. I also realised that to be a good surgeon you need to be fully aware of current evidence to implement it in clinical practice, hence I developed a passion for surgical research and is one aspect of clinical practice which I thoroughly enjoy.

HBSN: Could you share any particular lifestyle habits or interests that have positively impacted your career?

Prof. Pandanaboyana:  I think attention to detail is the most important aspect if you want to be a hepatobiliary surgeon. And that's something I've learned through research — paying attention to detail in clinical work and during surgeries. In fact, having that attention to detail at work has also improved my personal lifestyle, whether it's looking after myself or my family. Another aspect that's made a huge difference in my personal life is having a pet. I have a dog, and having a pet at home, going out, and spending weekends with my kids and the dog has made a huge impact. I think it's helped me maintain a good work-life balance.