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The study is designed to primarily investigate the safety of MIPD&nbsp;in terms of overall complications (safety)&nbsp;and furthermore to assess if MIPD is superior to OPD in terms of time to functional recovery.&nbsp;<br></div><div><br></div><div>Volume and experience requirements for participatings centers/surgeons:<br></div><div>- Annual volume of &gt;30 MIPD/year, before participation in the study<br></div><div>- Surgeon experience of at least&nbsp;60 MIPD and&nbsp;60 OPD<br></div><div>- Centers randomize for either robot-assisted surgery or laparoscopic surgery, according to their expertise</div><div><br></div><div>The protocol was designed according to the SPIRIT guidelines.<br></div><div><br><strong>Study population:&nbsp;</strong><br></div><div><strong>​</strong>In total, 288&nbsp;patients (192 minimally invasive arm and 96 open arm) with an indication for elective&nbsp;pancreatoduodenectomy&nbsp;for any pancreatic or peri-ampullary neoplasm will be 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