Research Group
Zerbi Group
Pancreatic Surgery and Engineering Lab
Our laboratory is dedicated to studying the biomechanical properties of the pancreas and developing engineering-based solutions to support pancreatic surgery. Our goal is to improve surgical outcomes and contribute to increasingly personalized and effective patient care.
The challenge
Pancreatic surgery is among the most complex procedures in the operating room, due to both the anatomical location and the unique properties of the organ. However, most surgical tools and materials currently used for pancreatic procedures are not specifically designed for the pancreas—they are often adapted from instruments developed for other organs. This mismatch is problematic, as each organ has distinct anatomical and mechanical characteristics. In particular, the pancreas produces a highly corrosive digestive fluid that can erode sutures after surgery, increasing the risk of hemorrhage or infection.
To address this challenge, researchers are working to characterize the mechanical properties of pancreatic tissue using specialized equipment. These data will enable the development of tailored surgical adhesives and sutures, and ultimately the creation of a realistic artificial pancreas. Such a model would provide surgeons with a highly realistic simulation tool and a platform to test and refine surgical techniques and materials, advancing both training and innovation in pancreatic surgery.
Main Research Areas
From Living Tissue to Phantom
Improving outcomes in complex procedures like pancreatoduodenectomy starts with a precise understanding of the tissues involved. Thanks to the close synergy between clinicians and engineers, our laboratory directly analyzes native pancreatic tissues sourced from the operating room to characterize their mechanical behavior—measuring stiffness, viscoelasticity, and suture resistance through customized protocols involving indentation, rheometry, and tensile testing.
The experimental data directly support the fabrication of high-fidelity pancreatic phantoms using application-driven blends of silicones and hydrogels, engineered to replicate the mechanical and anatomical features of living tissue. Designed to simulate complex anatomical challenges, these phantoms aim to reduce learning curves and complications in advanced procedures, while also serving a wide range of applications—from surgical training and planning to device testing—with potential for extension to other soft tissues through interdisciplinary collaboration. This project is also supported by the Ministry of Health, project code RF-2021-12372635.
Towards Patient-Tailored Models of Pancreatic Cancer
Our research focuses on the mechanical characterization of pancreatic ductal adenocarcinoma (PDAC) tissue to better understand its viscoelastic properties and their impact on treatment permeability. This project builds upon other work on healthy pancreatic tissue and aims to extend the analysis to malignant samples using advanced indentation techniques. The ultimate goal is to develop realistic 3D-printed phantoms of pancreatic cancer to support surgical training and personalized therapeutic strategies.
The project is highly interdisciplinary, involving close collaboration with Dr. Silvia Carrara from the Echoendoscopy Unit, whose expertise in elastography and endoscopic biopsy is crucial for correlating mechanical data with imaging features. Additionally, the Collaboration with Eng. Riccardo Levi from the Artificial Intelligence Unit to integrate radiomic analysis and machine learning models for comprehensive tumor profiling. This synergy between clinical, engineering, and computational domains is essential to advance translational research and improve outcomes for patients with PDAC. This project is supported by a grant from Fondazione Poggi-Villoresi.
Innovative Glue for Safer Pancreatic Surgery
In parallel, another key goal of our research is the development of a surgical glue specifically designed for pancreatic surgery to prevent postoperative pancreatic fistula (POPF), one of the most frequent and serious complications following pancreatic surgery. We aim to design a novel glue combining optimal adhesion strength, biocompatibility and controlled biodegradation.
By advancing this targeted solution, we strive to bridge the gap between laboratory innovation and clinical practice, ultimately enabling safer, more effective pancreatic surgeries and improving patient outcomes. The project is partially supported by a PRIN grant.
Selected publications
Outcomes after pancreatoduodenectomy and total pancreatectomy in patients with a high-risk pancreatic anastomosis: An entropy balance analysis.
Updates in the management of postoperative pancreatic fistula.
Delta Radiomic Features Predict Resection Margin Status and Overall Survival in Neoadjuvant-Treated Pancreatic Cancer Patients.
Clinical usefulness of routinely performed drain fluid cultures after pancreaticoduodenectomy. A new ally to predict patients’ outcomes?
Analysis of the Mechanical Characteristics of Human Pancreas through Indentation: Preliminary In Vitro Results on Surgical Samples.
Total Pancreatectomy With Islet Autotransplantation as an Alternative to High-risk Pancreatojejunostomy After Pancreaticoduodenectomy: A Prospective Randomized Trial.
The Choice of the Most Appropriate Suture Threads for Pancreatic Anastomoses on the Basis of Their Mechanical Characteristics.
A machine learning risk model based on preoperative computed tomography scan to predict postoperative outcomes after pancreatoduodenectomy.
Total pancreatectomy as alternative to pancreatico-jejunal anastomosis in patients with high fistula risk score: the choice of the fearful or of the wise?
The evolution of post-operative pancreatic fistula (POPF) classification: A single-center experience.
Group members
