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Robotic spleen-preserving total gastrectomy for gastric cancer: comparison with conventional laparoscopic procedure

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Abstract

Background

Robotic systems recently have been introduced to overcome technical limitations of conventional laparoscopic surgery, especially for complex procedures. Laparoscopic spleen-preserving total gastrectomy with D2 lymph node (LN) dissection (LTGD2) is one of the most complicated procedures. We hypothesized that robotic LN dissection would be more thorough and accurate. We compared robotic spleen-preserving total gastrectomy with D2 LN dissection (RTGD2) with LTGD2 to investigate the impact of robotics.

Methods

Clinicopathologic characteristics and short-term and long-term outcomes of RTGD2 (n = 51) versus LTGD2 (n = 58) in gastric adenocarcinoma patients were extracted from a prospectively designed database and analyzed retrospectively.

Results

There was no difference of patients’ characteristics between groups. Mean operation time of RTGD2 was longer than LTGD2 (p < 0.001), and no differences in tumor histology, size, location, and TNM stage were seen. Total retrieved LNs from RTGD2 was similar to LTGD2 (mean 47.2 vs. 42.8, respectively), as were retrieved LNs at splenic hilum (1.3 vs. 0.8). However, mean numbers of retrieved LNs along the splenic artery from RTGD2 was higher than LTGD2 (2.3 vs. 1.0, respectively; p = 0.013), as was also the case at the splenic hilum and artery (3.6 vs. 1.9, p = 0.014). Postoperative complication (16 vs. 22 %, p = 0.374) and overall and disease-free survival between the two groups were not significantly different (p = 0.767 and p = 0.666, respectively).

Conclusions

Robotic spleen-preserving total gastrectomy with D2 LN dissection is feasible. Operation time and retrieved total LNs and splenic hilar LNs in the robotic procedure are acceptable.

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Acknowledgments

This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (1020410). We acknowledge the assistance of BioScience Writers, LLC (Houston, TX, USA) in copyediting of the manuscript and corrections of English language usage.

Disclosures

Taeil Son, Joong Ho Lee, Yoo Min Kim, Hyoung-Il Kim, Sung Hoon Noh, and Woo Jin Hyung have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Graduate School, Yonsei University College of Medicine, Seoul, South Korea

    Taeil Son, Joong Ho Lee & Yoo Min Kim

  2. Department of Surgery, Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea

    Taeil Son

  3. Department of Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea

    Yoo Min Kim

  4. Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752, South Korea

    Hyoung-Il Kim, Sung Hoon Noh & Woo Jin Hyung

  5. Gastric Cancer Clinic, Severance Hospital, Yonsei University Health System, Seoul, South Korea

    Hyoung-Il Kim, Sung Hoon Noh & Woo Jin Hyung

  6. Robot and MIS Center, Severance Hospital, Yonsei University Health System, Seoul, South Korea

    Woo Jin Hyung

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  1. Taeil Son
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  2. Joong Ho Lee
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Correspondence to Woo Jin Hyung.

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Son, T., Lee, J.H., Kim, Y.M. et al. Robotic spleen-preserving total gastrectomy for gastric cancer: comparison with conventional laparoscopic procedure. Surg Endosc 28, 2606–2615 (2014). https://doi.org/10.1007/s00464-014-3511-0

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  • DOI: https://doi.org/10.1007/s00464-014-3511-0

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