Robot‐assisted completion gastrectomy preserving interposed jejunum in remnant gastric cancer following a proximal gastrectomy reconstructed by jejunal interposition: A case report

Abstract

Minimally invasive completion gastrectomy is technically demanding and comprises a variety of procedures depending on the previous operation. We present herein a case of robot-assisted completion gastrectomy preserving the interposed jejunum in remnant gastric cancer following a proximal gastrectomy reconstructed by jejunal interposition. A 76-year-old, male patient experienced newly developed stage cT1bN0M0 gastric cancer in the distal remnant stomach 5 years after his initial proximal gastrectomy. Endoscopic submucosal dissection was not feasible because of tumor depth and poor cancer cell differentiation. The robotic approach was chosen because of the early cancer stage, prior laparoscopic surgery, and the patient's advanced age. The interposed jejunum was successfully preserved, and a new overlap anastomosis was created between it and the retrocolic Roux-en-Y limb. Robot-assisted completion gastrectomy was safely performed even after a proximal gastrectomy with jejunal interposition.

Robot‐assisted total remnant gastrectomy for interposed jejunal pouch dysfunction 25 years after proximal gastrectomy for gastric cancer: A case report

“…Furthermore, Kanai et al recommended that a surgeon must have experience of at least 20 robot-assisted gastrectomies to be considered adept at performing such a technically demanding RATRG. 10 In our case, we could perform the operation safely without open conversion by a surgeon with experience of performing robot-assisted gastrectomy in about 170 cases, including three cases of total remnant gastrectomy after DG.…”

“…Thus, while RATRG after DG has been reported, insufficient research has been conducted on RATRG after PG. Kanai et al 10 reported safe robot‐assisted surgery for remnant gastric cancer after PG with jejunal interposition. They mentioned that robot‐assisted surgery with multiple joints is minimally invasive, even in the presence of adhesions.…”

Robotically assisted total gastrectomy for lymphadenopathy after long-term follow-up for multiple type 1 gastric neuroendocrine tumor (NET): a case report

“…Considering the potential for recurrence after a partial or subtotal gastrectomy, minimally invasive surgery, such as laparoscopic or robotically assisted surgery, is preferable to conventional open surgery, because it can be done with a small incision and causes less adhesion, enabling a second operation to be performed more easily and safely [ 14 ]. Moreover, a recent study suggested that robotically assisted surgery has the potential to reduce postoperative complications, especially intra-abdominal complications, to a greater extent than laparoscopic surgery owing to multi-joint articulation and 3D magnification available in the former [ 15 ].…”