Robotic gastrectomy for gastric cancer: surgical techniques and clinical merits.
BACKGROUND
Robotic gastrectomy in the setting of gastric cancer is reported by some investigators. However, no study has compared robotic surgery with open or laparoscopic surgery for patients with gastric cancer. This study aimed to determine the clinical benefits of robotic gastrectomy over open and laparoscopic gastrectomy for the treatment of gastric cancer.


METHODS
After the introduction of the da Vinci surgical system in November 2007 at the authors' hospital, 18 robotic gastrectomies were performed from 31 December 2007 to 30 June 2008. The prospective data from gastric cancer patients who underwent gastrectomies (16 robotic, 11 laparoscopic, and 12 open) during the same period were retrospectively analyzed.


RESULTS
Sex, age, comorbidity, extent of lymphadenectomy, pT stage, lymph node metastasis, and number of lymph nodes retrieved were similar among the three groups. The estimated blood loss was significantly less in the robotic gastrectomy group than in the open group (p = 0.0312), and the postoperative hospital stay in the robotic group was significantly shorter than in the open and laparoscopic gastrectomy groups (p < 0.001). Postoperative morbidity and time to first flatus were similar in the three groups. There was no open or laparoscopic conversion in the robotic group. No postoperative mortality occurred in any group.


CONCLUSIONS
Robotic gastrectomy for the treatment of gastric cancer is a feasible and safe procedure in the hands of experienced laparoscopic surgeons. Robotic gastrectomy offers better short-term surgical outcomes than the open and laparoscopic methods. Furthermore, this procedure may be a preferable alternative for the treatment of gastric cancer.
Kim
Min-Chan
MC
Department of Surgery, Minimally Invasive and Robot Center, Dong-A University College of Medicine, 3-1 Dongdaeshin-Dong, Seo-Gu, Busan 602-715, Korea. mckim@donga.ac.kr
Heo
Geon-Ung
GU
Jung
Ghap-Joong
GJ
D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D018709:Statistics, Nonparametric; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome
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