title: Emerging Role of Robot-assisted Gastrectomy: Analysis of Consecutive 200 Cases.
abstract: OBJECTIVE
  Robotic surgery for gastric cancer is a promising alternative to laparoscopic surgery, but the data are limited. We aimed to evaluate whether gaining experience in robotic gastrectomy could improve surgical outcomes in the treatment of gastric cancer.
  
  
  METHODS
  Two hundred and seven consecutive cases of patients with clinical stage I gastric cancer who underwent robotic surgery at the National Cancer Center of Korea between February 2009 and February 2012 were retrospectively reviewed. Surgical outcomes were analyzed and compared between the initial 100 and later 100 cases.
  
  
  RESULTS
  Seven patients required conversion to open surgery and were excluded from further analysis. The mean operating time for all patients was 248.8 minutes, and mean length of hospitalization was 8.0 days. Twenty patients developed postoperative complications. Thirteen were managed conservatively, while 6 had major complications requiring invasive procedures. One mortality occurred owing to myocardial infarction. Operating time was significantly shorter in the latter 100 cases than in the initial 100 cases (269.9 versus 233.5 minutes, P<0.001). The number of retrieved lymph nodes was significantly greater in the latter cases (35.9 versus 39.9, P=0.032). The hospital stay of patients with complications was significantly longer in the initial cases than in the latter cases (16 versus 7 days, P=0.005).
  
  
  CONCLUSIONS
  Increased experience with the robotic procedure for gastric cancer was associated with improved outcomes, especially in operating time, lymph node retrieval, and shortened hospital stay of complicated patients. Further development of surgical techniques and technology might enhance the role of robotic surgery for gastric cancer.
authors: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Ji Yeon
authors: JY
authors: Park
authors: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Young-Woo
authors: YW
authors: Kim
authors: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Keun Won
authors: KW
authors: Ryu
authors: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Bang Wool
authors: BW
authors: Eom
authors: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
authors: Hong Man
authors: HM
authors: Yoon
authors: Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea. ; Department of Surgery, Klinikum Rechts der Isar der Technischen Universität München, Munich, Germany.
authors: Daniel
authors: D
authors: Reim
keywords: Laparoscopy; Minimally invasive surgical procedures; Robotics; Stomach neoplasms