S Amore Bonapasta1, F Guerra2, C Linari2, M Annecchiarico2, B Boffi2, M Calistri2, A Coratti2. 1. Division of Oncological and Robotic General Surgery, Careggi University Hospital, 50134, Florence, Italy. stefano.amore.b@gmail.com. 2. Division of Oncological and Robotic General Surgery, Careggi University Hospital, 50134, Florence, Italy.
Abstract
BACKGROUND: Laparoscopic gastrectomy for cancer is commonly considered a challenging procedure. The technical drawbacks of laparoscopy have been addressed by robotic technology, which can facilitate demanding reconstructions and fine dissection. These features confer potential advantages in the execution of lymphadenectomy. OBJECTIVES: Here, we illustrate our technique of robotic gastrectomy and discuss advantages and drawbacks by reviewing the current literature. MATERIALS AND METHODS: We describe our technique for robot-assisted distal and total gastrectomy for cancer and assess the current literature dealing with short-term outcomes, immediate oncologic measures, and long-term oncologic outcomes of robot-assisted gastrectomy, in comparison with conventional laparoscopic and open surgery. RESULTS: The robotic procedure seems to be as safe and effective as conventional gastrectomy for gastric cancer, with a longer operative time and decreased blood loss in comparison with laparoscopic gastrectomy. CONCLUSION: The technical advantages offered by robotics could help to standardize minimally invasive D2 lymphadenectomy and enable surgeons to perform this procedure routinely. Despite the scarcity of long-term data on survival, immediate oncological measures (lymph node yield and margin status) are encouraging. Further studies investigating the long-term oncological outcomes are required.
BACKGROUND: Laparoscopic gastrectomy for cancer is commonly considered a challenging procedure. The technical drawbacks of laparoscopy have been addressed by robotic technology, which can facilitate demanding reconstructions and fine dissection. These features confer potential advantages in the execution of lymphadenectomy. OBJECTIVES: Here, we illustrate our technique of robotic gastrectomy and discuss advantages and drawbacks by reviewing the current literature. MATERIALS AND METHODS: We describe our technique for robot-assisted distal and total gastrectomy for cancer and assess the current literature dealing with short-term outcomes, immediate oncologic measures, and long-term oncologic outcomes of robot-assisted gastrectomy, in comparison with conventional laparoscopic and open surgery. RESULTS: The robotic procedure seems to be as safe and effective as conventional gastrectomy for gastric cancer, with a longer operative time and decreased blood loss in comparison with laparoscopic gastrectomy. CONCLUSION: The technical advantages offered by robotics could help to standardize minimally invasive D2 lymphadenectomy and enable surgeons to perform this procedure routinely. Despite the scarcity of long-term data on survival, immediate oncological measures (lymph node yield and margin status) are encouraging. Further studies investigating the long-term oncological outcomes are required.
Entities:
Keywords:
Gastrectomy; Gastric cancer; Lymphadenectomy; Minimally invasive surgery; Robotic surgery
Authors: Andrea Coratti; Mario Annecchiarico; Michele Di Marino; Edoardo Gentile; Francesco Coratti; Pier Cristoforo Giulianotti Journal: World J Surg Date: 2013-12 Impact factor: 3.352