Advantages of the Left-handed Ultrasonic Shears Technique for Robotic Gastrectomy

Abstract

The aim of this study was to investigate advantages of the left-handed ultrasonic shears technique in robotic gastrectomy for gastric cancer.Methods: We retrospectively analyzed 67 consecutive gastric cancer patients who underwent robotic gastrectomy. Fifty-six patients underwent gastrectomy with the left-handed ultrasonic shears technique (the left hand group), and 11 patients underwent surgery with the conventional approach (the conventional group). Intraoperative and postoperative outcomes were compared between the 2 groups.Results: Operative blood loss, morbidity, and mortality were similar between the 2 groups. We observed a trend toward a shorter operation time and higher number of retrieved lymph nodes in the left hand group compared with the conventional group. Console time (docking-gastrectomy) in the left hand group was significantly shorter than in the conventional group (192.20 vs. 218.36 min, P < 0.05). In robotic distal gastrectomy, both operation time and console time in the left hand group were significantly shorter than in the conventional group (276.10 vs. 354.80 min, 176.43 vs. 209.20 min, P < 0.05 for both). The postoperative intra-abdominal infectious complication (Clavien Dindo ≥ 1) rate in the left hand group was significantly lower than that in the conventional group (0% vs. 20%, P < 0.05).Conclusions: Use of the left-handed ultrasonic shears technique is safe and provides a technically superior operative environment with satisfactory postoperative results.

Utility of robotic surgery for Siewert type II/III adenocarcinoma of esophagogastric junction: transhiatal robotic versus laparoscopic approach

“…The surgical indications and lymph node (LN) dissection were defined using the Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition). The surgical techniques of RS and LS in our institute were reported previously [ 22 – 24 ]. We performed extended total gastrectomy (TG) with lower mediastinal LN dissection or extended proximal gastrectomy (PG) with lower mediastinal LN dissection for Siewert II/III AEG.…”

Utility of robotic surgery for Siewert type II/III adenocarcinoma of esophagogastric junction: transhiatal robotic versus laparoscopic approach

“…The surgical techniques of RS and LS in our institute were reported previously. [22][23][24] We performed extended total gastrectomy (TG) with lower mediastinal LN dissection or extended proximal gastrectomy (PG) with lower mediastinal LN dissection for Siewert II/III AEG. Intraoperative gastric ber was routinely employed.…”