Robotic gastrectomy for gastric cancer: Current evidence

Abstract

The robotic system has gained wide acceptance in specialties such as urological and gynecological surgery. It has also been applied in the field of upper gastrointestinal surgery. Since the first implementation of the robotic system for the treatment of gastric adenocarcinoma, the procedure has been found to be safe and feasible. Although robotic gastrectomy does not meet our expectations and yield better results than laparoscopic gastrectomy, this procedure seems to provide several advantages over laparoscopy such as reduced blood loss, shorter learning curves and increased number of retrieved lymph nodes. However, as many case series, including a recent multicenter study, have revealed, higher cost and longer operation time are the major limitations of robotic gastrectomy. Furthermore, there are no results from well‐designed randomized clinical trials comparing the two procedures. New procedures in much more technically demanding cases will test the genuine benefits of robotic gastrectomy.

Essential updates 2017/2018: Recent topics in the treatment and research of gastric cancer in Japan

“…These updates could provide essential and new insights into gastric cancer treatments in practical clinical settings. However, in the present review, we could summarize only some of the major topics and had to exclude topics on less invasive surgeries such as laparoscopic and robotic gastrectomy and clinical study regarding the surgical approach based on the sentinel node concept for early gastric cancer . However, additional updates on major topics including these topics could be summarized in the near future.…”

Totally minimally invasive radical gastrectomy with the da Vinci Xi® robotic system versus straight laparoscopy for gastric adenocarcinoma

“…Disadvantage of the robotic operations in terms of longer operating time compared to laparoscopy was documented previously. 19,20 Robotic surgery for the treatment of gastric cancer is in the beginning phase in Turkey. Role of caseload on reducing the time spend in the operating room has been well documented previously.…”

Minimally invasive gastrectomy for cancer and anastomotic options

“…However, high operating times may be related to the learning curve. A Korean study comparing their initial (first 500 cases) vs later RG experiences found a significant reduction in operative time from a mean of 229.3 minutes to 215.7 minutes ( P < .001), which is more comparable to laparoscopic procedure times 29 …”