title: Clinical application of image-enhanced minimally invasive robotic surgery for gastric cancer: a prospective observational study.
abstract: BACKGROUND
  This study was performed to validate the feasibility and role of image-guided robotic surgery using preoperative computed tomography (CT) images for the treatment of gastric cancer.
  
  
  METHODS
  Twelve patients scheduled to undergo robotic gastrectomy for gastric cancer were registered. Vessels encountered during gastrectomy were reconstructed using 3D software and their anatomical variation was evaluated using preoperatively performed CT-angiography. The vascular information was transferred to a robot console using a multi-input display mode. Radiologic findings acquired from preoperative CT by the radiologist were compared with intraoperative findings of the surgeon. This study is registered with                      www.clinicaltrials.gov                                         as NCT01338948.
  
  
  RESULTS
  All 12 robotic gastrectomies were performed without any problems. All anatomical data acquired using 3D software were transferred successfully during surgery. Intraoperative vascular images depicted vasculatures around the stomach and could identify important vascular variations. During surgery, relevant vascular information led the surgeon to branch sites and facilitated lymphadenectomy around the vessels. Image-guidance during the operation provided a vascular map and enabled the surgeon to avoid accidental bleeding and damage to other organs by preventing vascular injuries.
  
  
  CONCLUSIONS
  Image-guided robotic surgery for gastric cancer using preoperative CT-angiography reconstructed during operation by a surgically trained radiologist who could adjust the images by anticipating the operative procedure was feasible and improved the efficiency of surgery by eliminating the possibility of vascular injuries.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, 50 Yonsei-ro Seodaemun-gu, Seoul, 120-752, Korea.
authors.forename: Yoo Min
authors.initials: YM
authors.lastname: Kim
authors.forename: Song-Ee
authors.initials: SE
authors.lastname: Baek
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Lim
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Hyung
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011446:Prospective Studies; D012371:Robotics; D013274:Stomach Neoplasms / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed