title: Advances in Laparoscopic and Robotic Gastrectomy for Gastric Cancer.
abstract: Robot-assisted gastrectomy has been reported to be a safe alternative to both conventional laparoscopy and the open approach for treating early gastric carcinoma. Currently, there are a limited number of published reports on this technique in the literature. We assessed the current status of robotic and laparoscopic surgery in the treatment of gastric cancer and compared the operative outcomes, learning curves, and oncological outcome of the two approaches. Robotic gastrectomy offers benefits that include increased ease of performing D2 lymph node dissection and reduced blood loss compared with laparoscopic gastrectomy. However, the operative time is longer, and robotic gastrectomy is more costly for the patients. Regarding to the operative and oncological outcomes, there appears to be no significant differences between laparoscopic and robotic gastrectomies after the surgeon overcomes the associated learning curves. Sharing the available knowledge regarding laparoscopic and robotic gastrectomies could shorten these learning curves. For elder patients, minimally invasive surgery that decreases the postoperative recovery time should be considered the preferred treatment. Prospective randomized studies are required to compare the surgical and oncological outcomes among laparoscopic, robotic, and open surgeries for both early and advanced gastric cancer.
authors.affiliation: Department of Urology, Cheng Hsin General Hospital, Taipei City, Taiwan.|School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Sheng-Han
authors.initials: SH
authors.lastname: Tsai
authors.affiliation: Department of Radiology, Taipei Veterans General Hospital, Taipei City, Taiwan.|School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Chien-An
authors.initials: CA
authors.lastname: Liu
authors.affiliation: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei City, Taiwan, 11217.|School of Medicine, National Yang-Ming University, Taipei City, Taiwan.|Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Kuo-Hung
authors.initials: KH
authors.lastname: Huang
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei City, Taiwan.|Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei City, Taiwan.
authors.forename: Yuan-Tzu
authors.initials: YT
authors.lastname: Lan
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei City, Taiwan.|Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Chen
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei City, Taiwan.|Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yee
authors.initials: Y
authors.lastname: Chao
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei City, Taiwan.|National Yang-Ming University Hospital, Yilan City, Taiwan.
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Lo
authors.affiliation: School of Medicine, National Yang-Ming University, Taipei City, Taiwan.|Department of Pathology, Taipei Veterans General Hospital, Taipei City, Taiwan.
authors.forename: Anna Fen-Yau
authors.initials: AF
authors.lastname: Li
authors.affiliation: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei City, Taiwan, 11217.|School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Chew-Wun
authors.initials: CW
authors.lastname: Wu
authors.affiliation: Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan.|Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei City, Taiwan.|Institute of Pharmacology, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Shih-Hwa
authors.initials: SH
authors.lastname: Chiou
authors.affiliation: Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan.|Division of Medical Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Muh-Hwa
authors.initials: MH
authors.lastname: Yang
authors.affiliation: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei City, Taiwan, 11217.|School of Medicine, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Shyr
authors.affiliation: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei City, Taiwan, 11217. s821094@hotmail.com.|School of Medicine, National Yang-Ming University, Taipei City, Taiwan. s821094@hotmail.com.
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Fang
mesh_terms: D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008197:Lymph Node Excision / Q000379:methods; D012371:Robotics / Q000379:methods; D013270:Stomach / Q000601:surgery*; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Elderly; Gastric cancer; Laparoscopic; Lymph node dissection; Robotic