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Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits

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Abstract

Background

Robotic gastrectomy in the setting of gastric cancer is reported by some investigators. However, no study has compared robotic surgery with open or laparoscopic surgery for patients with gastric cancer. This study aimed to determine the clinical benefits of robotic gastrectomy over open and laparoscopic gastrectomy for the treatment of gastric cancer.

Methods

After the introduction of the da Vinci surgical system in November 2007 at the authors’ hospital, 18 robotic gastrectomies were performed from 31 December 2007 to 30 June 2008. The prospective data from gastric cancer patients who underwent gastrectomies (16 robotic, 11 laparoscopic, and 12 open) during the same period were retrospectively analyzed.

Results

Sex, age, comorbidity, extent of lymphadenectomy, pT stage, lymph node metastasis, and number of lymph nodes retrieved were similar among the three groups. The estimated blood loss was significantly less in the robotic gastrectomy group than in the open group (p = 0.0312), and the postoperative hospital stay in the robotic group was significantly shorter than in the open and laparoscopic gastrectomy groups (p < 0.001). Postoperative morbidity and time to first flatus were similar in the three groups. There was no open or laparoscopic conversion in the robotic group. No postoperative mortality occurred in any group.

Conclusion

Robotic gastrectomy for the treatment of gastric cancer is a feasible and safe procedure in the hands of experienced laparoscopic surgeons. Robotic gastrectomy offers better short-term surgical outcomes than the open and laparoscopic methods. Furthermore, this procedure may be a preferable alternative for the treatment of gastric cancer.

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References

  1. National Institutes of Health Consensus Development Conference Statement (1993) Gallstones and laparoscopic cholecystectomy. J Laparoendosc Surg 3:77–90

    Google Scholar 

  2. Kim MC, Kim W, Kim HH, Ryu SW, Ryu SY, Song KY, Lee HJ, Cho GS, Han SU, Hyung WJ, Korean Laparoscopic Gastrointestinal Surgery Study (KLASS) Group (2008) Risk factors associated with complication following laparoscopy-assisted gastrectomy for gastric cancer: a large-scale Korean multicenter study. Ann Surg Oncol 15:2692–2700

    Article  PubMed  Google Scholar 

  3. Shehzad K, Mohiuddin K, Nizami S, Sharma H, Khan IM, Memon B, Memon MA (2007) Current status of minimal access surgery for gastric cancer. Surg Oncol 16:85–98

    Article  PubMed  Google Scholar 

  4. Kim W, Song KY, Lee HJ, Han SU, Hyung WJ, Cho GS (2008) The impact of comorbidity on surgical outcomes in laparoscopy-assisted distal gastrectomy. Ann Surg 248:793–799

    Article  PubMed  Google Scholar 

  5. Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N, Japanese Laparoscopic Surgery Study Group (2007) A multicenter study on oncologic outcome of laparoscopic gastrectomy for early gastric cancer in Japan. Ann Surg 245:68–72

    Article  PubMed  Google Scholar 

  6. Lanfranco AR, Castellanos AE, Desai JP, Meyers WC (2004) Robotic surgery: a current perspective. Ann Surg 239:14–21

    Article  PubMed  Google Scholar 

  7. Hanly EJ, Talamini MA (2004) Robotic abdominal surgery. Am J Surg 188:19S–26S

    Article  PubMed  Google Scholar 

  8. Gutt CN, Oniu T, Mehrabi A, Kashfi A, Schemmer P, Büchler MW (2004) Robot-assisted abdominal surgery. Br J Surg 91:1390–1397

    Article  CAS  PubMed  Google Scholar 

  9. Cadière GB, Himpens J, Germay O, Izizaw R, Degueldre M, Vandromme J, Capelluto E, Bruyns J (2001) Feasibility of robotic laparoscopic surgery:146 cases. World J Surg 25:1467–1477

    PubMed  Google Scholar 

  10. Atug F, Castle EP, Woods M, Davis R, Thomas R (2006) Robotics in urologic surgery: an evolving new technology. Int J Urol 13:857–863

    Article  PubMed  Google Scholar 

  11. Anderson C, Ellenhorn J, Hellan M, Pigazzi A (2007) Pilot series of robot-assisted laparoscopic subtotal gastrectomy with extended lymphadenectomy for gastric cancer. Surg Endosc 21:1662–1666

    Article  PubMed  Google Scholar 

  12. Hashizume M, Sugimachi K (2003) Robotic-assisted gastric surgery. Surg Clin North Am 83:1429–1444

    Article  PubMed  Google Scholar 

  13. Giulianotti PC, Coratti A, Angelini M, Sbrana F, Cecconi S, Balestracci T, Caravaglios G (2003) Robotics in general surgery: personal experience in a large community hospital. Arch Surg 138:777–784

    Article  PubMed  Google Scholar 

  14. Pugliese R, Maggioni D, Sansonna F, Ferrari GC, Forgione A, Costanzi A, Magistro C, Pauna J, Di Lernia S, Citterio D, Brambilla C (2009) Outcomes and survival after laparoscopic gastrectomy for adenocarcinoma: analysis on 65 patients operated on by conventional or robot-assisted minimal access procedures. Eur J Surg Oncol 35:281–288

    CAS  PubMed  Google Scholar 

  15. Kim MC, Kim HH, Jung GJ (2005) Surgical outcome of laparoscopy-assisted gastrectomy with extraperigastric lymph node dissection for gastric cancer. Eur J Surg Oncol 31:401–405

    Article  PubMed  Google Scholar 

  16. Sano T, Sasako M, Yamamoto S, Nashimoto A, Kurita A, Hiratsuka M, Tsujinaka T, Kinoshita T, Arai K, Yamamura Y, Okajima K (2004) Gastric cancer surgery: morbidity and mortality results from a prospective randomized controlled trial comparing D2 and extended paraaortic lymphadenectomy. Japan Clinical Oncology Group study 9501. J Clin Oncol 22:2767–2773

    Article  PubMed  Google Scholar 

  17. Huscher CG, Mingoli A, Sgarzini G, Sansonetti A, Di Paola M, Recher A, Ponzano C (2005) Laparoscopic versus open subtotal gastrectomy for distal gastric cancer: five-year results of a randomized prospective trial. Ann Surg 241:232–237

    Article  PubMed  Google Scholar 

  18. Isomoto H (2009) Endoscopic submucosal dissection for early gastric cancer: a large-scale follow-up study. Gut 58:331–336

    Article  CAS  PubMed  Google Scholar 

  19. Wu CW, Hsiung CA, Lo SS, Hsieh MC, Chen JH, Li AF, Lui WY, Whang-Peng J (2006) Nodal dissection for patients with gastric cancer: a randomised controlled trial. Lancet Oncol 7:309–315

    Article  CAS  PubMed  Google Scholar 

  20. Uyama I, Sugioka A, Fujita J, Komori Y, Matsui H, Hasumi A (1999) Laparoscopic total gastrectomy with distal pancreatosplenectomy and D2 lymphadenectomy for advanced gastric cancer. Gastric Cancer 2:230–234

    Article  PubMed  Google Scholar 

  21. Kim MC, Choi HJ, Jung GJ, Kim HH (2007) Techniques and complications of laparoscopy-assisted distal gastrectomy for gastric cancer. Eur J Surg Oncol 33:700–705

    PubMed  Google Scholar 

  22. Kim KH, Kim MC, Jung GJ, Kim HH (2006) The impact of obesity on LADG for early gastric cancer. Gastric Cancer 9:303–307

    Article  PubMed  Google Scholar 

  23. Kim MC, Kim KH, Kim HH, Jung GJ (2005) Comparison of laparoscopy-assisted by conventional open distal gastrectomy and extraperigastric lymph node dissection in early gastric cancer. J Surg Oncol 91:90–94

    Article  PubMed  Google Scholar 

  24. Hiki N, Shimizu N, Yamaguchi H, Imamura K, Kami K, Kubota K, Kaminishi M (2006) Manipulation of the small intestine as a cause of the increased inflammatory response after open compared with laparoscopic surgery. Br J Surg 93:195–204

    Article  CAS  PubMed  Google Scholar 

  25. Shafer A, Boggess JF (2008) Robotic-assisted endometrial cancer staging and radical hysterectomy with the da Vinci surgical system. Gynecol Oncol 111:S18–S23

    Article  PubMed  Google Scholar 

  26. Tewari A, Kaul S, Menon M (2005) Robotic radical prostatectomy: a minimally invasive therapy for prostate cancer. Curr Urol Rep 6:45–48

    Article  PubMed  Google Scholar 

  27. Hyung WJ, Song C, Cheong JH, Choi SH, Noh SH (2007) Factors influencing operation time of laparoscopy-assisted distal subtotal gastrectomy: analysis of consecutive 100 initial cases. Eur J Surg Oncol 33:314–319

    Article  CAS  PubMed  Google Scholar 

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Acknowledgment

This study was supported by research funds from Dong-A University.

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Authors and Affiliations

  1. Department of Surgery, Minimally Invasive and Robot Center, Dong-A University College of Medicine, 3-1 Dongdaeshin-Dong, Seo-Gu, Busan, 602-715, Korea

    Min-Chan Kim, Geon-Ung Heo & Ghap-Joong Jung

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  1. Min-Chan Kim
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  2. Geon-Ung Heo
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  3. Ghap-Joong Jung
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Correspondence to Min-Chan Kim.

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Kim, MC., Heo, GU. & Jung, GJ. Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits. Surg Endosc 24, 610–615 (2010). https://doi.org/10.1007/s00464-009-0618-9

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  • DOI: https://doi.org/10.1007/s00464-009-0618-9

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