Updates in Surgery

, Volume 70, Issue 2, pp 181–187 | Cite as

Minimal-invasive gastrectomy: what the west can learn from the east?

  • Felix Berlth
  • Han-Kwang YangEmail author
Review Article
Part of the following topical collections:
  1. Gastric Cancer Surgery


Minimal-invasive gastrectomy has been established as commonly used method for the early gastric cancer in Korea and Japan. From the first laparoscopic cancer gastrectomy in 1992 in Japan, numerous prospective randomized trials from these two countries have gained the evidence for non-inferiority or even specific benefits compared to open surgery. In Korea, the “Korean Laparoscopic Gastrointestinal Surgical Study Group” (KLASS group) founded, in 2004, successfully gained evidence not only in regards of oncological safety of laparoscopic gastrectomy, but also for the impact of different reconstruction methods and alternative extents of luminal resection on postoperative outcome and quality of life. Awaited results of latest studies from Korea, Japan, and China may suggest laparoscopic approaches as an option even in advanced gastric cancers. These studies could potentially be the starting point to find the role of laparoscopic gastrectomy in the west, where the incidence of gastric cancer is rather lower; the cancers are mostly diagnosed in advanced stages, and often, a perioperative chemotherapy is applied. Robotic (-assisted) gastrectomy was not shown to be superior to laparoscopic resection in Korea, but new technological developments should continuously be evaluated in clinical trials regarding a potentially favorable learning curve, which might play a key role in regards of the limited case load per center of gastric cancer in the west. This review summarizes the history of laparoscopic cancer gastrectomy in Asia and points out the important steps of establishing a nation-wide scientific network to support the surgical routine by the necessary evidence with a focus on Korea.


Minimal-invasive surgery Gastric cancer KLASS Laparoscopic gastrectomy Robotic gastrectomy 



Felix Berlth is supported by the “German Research Foundation” (DFG).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  1. 1.Division of Gastrointestinal Surgery, Department of SurgerySeoul National University HospitalSeoulKorea
  2. 2.Cancer Research InstituteSeoul National UniversitySeoulKorea
  3. 3.Department of General, Visceral and Cancer SurgeryUniversity Hospital of CologneCologneGermany

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