Objective: To investigate the feasibility, safety and clinical application value of the “3+2” mode robotic distal panceatectomy using the da Vinci surgical system. 
Methods: The clinical data of 60 patients undergoing distal pancreatectomy using the da Vinci robotic surgical system from June 2017 to December 2018 were retrospectively analyzed. Of the patients, 30 cases underwent robotic distal pancreatectomy under a the “3+2” mode (observation group), namely, 3 mechanical arms 
(2 manipulator arms and 1 camera arm) and 2 assisting surgeons, with the second assisting surgeon substituting the third arm of the robot under the classical mode; another 30 cases underwent robotic distal pancreatectomy under the classical mode (control group). The main clinical variables were compared between the two groups. 
Results: The general clinical data were comparable between the two groups. There were no significant differences in term of intraoperative blood loss, open conversion rates, blood transfusion rates, time to postoperative gas passage, length of postoperative hospital stay and incidence rates of postoperative complications as well as spleen preserving rates in patients planned for spleen preservation between the two groups (all P>0.05), but the operative time was shorter and hospitalization cost was lower in observation group than those in control group (both P<0.05).
Conclusion: Using “3+2” mode of da Vinci robot in distal pancreatectomy can improve the surgical field, enhance the collaborative operation between the assisting surgeons, reduce hospitalization costs and shorten the operative time and learning curves. Moreover, it can achieve the similar clinical efficacy with that under the classical mode. The long-term clinical efficacy of this mode still needs further verification by future studies.