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Full robot-assisted gastrectomy: surgical technique and preliminary experience from a single center

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Abstract

The treatment of gastric cancer requires a multidisciplinary approach in which surgery plays the main role. The diffusion of minimally invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended lymphadenectomy. This surgical step can be facilitated through the use of a robot-assisted system. To date, there are few published articles discussing a full robotic approach that precisely show the different surgical steps. The aim of this study is to describe our experience, surgical techniques and the short-term results of a consecutive series of full robotic gastrectomies using the Da Vinci Surgical System. From November 2011 to January 2015, 17 patients with gastric cancer underwent curative resection by robotic approach for locally advanced tumors. In summary, there were 15 total gastrectomies with a Roux-en-Y esophagojejunostomy, one total gastrectomy with transverse colectomy and one sub-total gastrectomy. Resection margins were negative in all cases. Conversions occurred in two patients. Robot-assisted gastrectomy with extended lymphadenectomy is a safe technique and successfully allows an adequate lymph node harvest and optimal R0-resection rates with low postoperative morbidity. The learning curve appears to be shorter than in laparoscopic surgery. Further follow-up and randomized clinical trials are required to confirm the role of a robotic approach in gastric cancer surgery.

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Acknowledgments

The authors thank Pablo Ruiz, Isabel de Salas and Jan Lammel Lindemann.

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Authors and Affiliations

  1. General Surgery Department, Sanchinarro University Hospital, San Pablo University, CEU, C/Oña nº 10, 28050, Madrid, Spain

    Yolanda Quijano, Emilio Vicente, Benedetto Ielpo, Hipolito Duran, Eduardo Diaz, Isabel Fabra, Luis Malave, Valentina Ferri, Antonio Ferronetti & Riccardo Caruso

  2. Department of Pathology, Sanchinarro University Hospital, San Pablo University, CEU, Madrid, Spain

    Carlos Plaza

  3. Department of Surgical Sciences, “Sapienza” University of Rome, Rome, Italy

    Vito D’Andrea

Authors
  1. Yolanda Quijano
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  2. Emilio Vicente
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  3. Benedetto Ielpo
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  4. Hipolito Duran
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  5. Eduardo Diaz
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  6. Isabel Fabra
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  7. Luis Malave
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  8. Valentina Ferri
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  9. Antonio Ferronetti
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  10. Carlos Plaza
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  11. Vito D’Andrea
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  12. Riccardo Caruso
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Corresponding author

Correspondence to Riccardo Caruso.

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Conflict of interest

Y. Quijano, Prof. M. D. E. Vicente Prof. M. D. B. Ilepo, H. Duran, E. Diaz, I. Fabra, L. Malave, V. Ferri, A, Ferronetti, C. Plaza, V. D’Andrea and R. Caruso declare that they have no conflict of interest.

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study.

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Quijano, Y., Vicente, E., Ielpo, B. et al. Full robot-assisted gastrectomy: surgical technique and preliminary experience from a single center. J Robotic Surg 10, 297–306 (2016). https://doi.org/10.1007/s11701-016-0591-y

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  • DOI: https://doi.org/10.1007/s11701-016-0591-y

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