title: Robotic intragastric surgery: a new surgical approach for the gastric lesion.
abstract: BACKGROUND
  Intragastric surgery is accepted as a minimally invasive procedure for mucosal or submucosal lesions. Robotic surgery promises to extend the capabilities of the minimally invasive surgeon and many surgical specialties are applying this new technology. However, there is no report of robotic intragastric surgery. We describe the use of the da Vinci Surgical System for intraluminal mucosal resection of the stomach.
  
  
  METHODS
  We developed our porcine intragastric surgery model using the Tuebingen MIS Trainer. We set a tentative lesion on the posterior wall near the esophagocardiac junction (ECJ) of the stomach and performed mucosal resection of the lesion using the da Vinci Surgical System. We also performed closure of the defect after mucosal resection and subsequent closure of the intentional gastric perforation.
  
  
  RESULTS
  Using our porcine intragastric surgery model, we successfully performed mucosal resection of the tentative lesion. We also smoothly completed closure of the defect and closure of the perforation without any complications. The mean size of the mucosa was 6 cm and the mean duration of the procedure was only 12 min.
  
  
  CONCLUSIONS
  The safety and efficacy of robotic intragastric surgery was preliminarily established in this study. However, further studies are needed to prove its practical feasibility in humans using the da Vinci Surgical System to make it an effective operation.
authors.affiliation: Department of Telesurgery and Geomedicine, Kanazawa University Graduate School of Medical Science, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan. yasumitsuhira@yahoo.co.jp
authors.forename: Yasumitsu
authors.initials: Y
authors.lastname: Hirano
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ishikawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Omura
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Inaki
authors.forename: Chikashi
authors.initials: C
authors.lastname: Hiranuma
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Waseda
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004867:Equipment Design; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D012371:Robotics / Q000295:instrumentation*; D013272:Stomach Diseases / Q000601:surgery*; D013552:Swine; D016896:Treatment Outcome