Surgical Endoscopy

, Volume 31, Issue 10, pp 4002–4009 | Cite as

Safety and feasibility of reduced-port robotic distal gastrectomy for gastric cancer: a phase I/II clinical trial

  • Seungho Lee
  • Jin Kyong Kim
  • Youn Nam Kim
  • Dong-Su Jang
  • Yoo Min Kim
  • Taeil Son
  • Woo Jin Hyung
  • Hyoung-Il KimEmail author



Theoretically, reducing the number of ports required in minimally invasive surgery for gastric cancer would further minimize trauma associated therewith. Advances in single-site surgery have afforded surgeons the ability to perform reduced-port distal gastrectomy via a robotic approach using the Single-Site™ system, eliminating restrictions on the movement of surgical instruments.


This phase I/II study was designed as a single-arm prospective trial of reduced-port robotic distal gastrectomy (RRDG) by a single surgeon (NCT02347956). From January to October 2015, 40 individuals scheduled to undergo robotic surgery for early gastric cancer were asked to participate in the trial. Nineteen were enrolled and underwent RRDG. The primary endpoints were 30-day morbidity and mortality.


No intraoperative event requiring conversion to laparoscopic or open surgery occurred, and no major complication was observed following RRDG (0.0% [80% CI (0.0–11.4%)]). Medians of operation time, blood loss, the number of retrieved lymph nodes, days until gas passing, and hospital stay were 190 min, 20 mL, 48, 3, and 5 days, respectively.


Deemed safe and feasible through the present trial, RRDG could be a valid alternative to conventional robot distal gastrectomy for managing early gastric cancer. Our reduced-port robotic surgery using the Single-Site system and a third robotic arm could potentially be applicable as a highly advanced, minimally invasive surgery for other solid organ diseases.


Early Gastric Cancer Visual Analogue Scale Score Retrieve Lymph Node Intuitive Surgical Needle Driver 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Reduced-port robotic distal gastrectomy


Confidence interval



This study was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2013R1A1A1007706). The authors would like to thank Anthony Thomas Milliken, ELS (Editing Synthase, Seoul, Korea) for his help with the editing of this manuscript and thank Soyoung Kim, Kyoung Hee Lee, and other nursing staff members for their professional help and enthusiasm.

Compliance with ethical standards


Mrs. Youn Nam Kim, Mr. Dong-Su Jang, Drs. Seungho Lee, Jin Kyong Kim, Yoo Min Kim, Taeil Son, Woo Jin Hyung, and Hyoung-Il Kim have no conflicts of interest or financial ties to disclose.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Department of SurgeryYonsei University College of Medicine, Yonsei University Health SystemSeoulSouth Korea
  2. 2.Department of BiostatisticsYonsei University College of MedicineSeoulSouth Korea
  3. 3.Department of SculptureHongik UniversitySeoulSouth Korea
  4. 4.Department of Surgery, CHA Bundang Medical CenterCHA University School of MedicineSeongnamSouth Korea
  5. 5.Minimally Invasive Surgery CenterYonsei University Health SystemSeoulSouth Korea
  6. 6.Open NBI Convergence Technology Research Laboratory, Severance HospitalYonsei University Health SystemSeoulSouth Korea

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