Full Robotic Gastrectomy with Extended (D2) Lymphadenectomy for Gastric Cancer: Surgical Technique and Preliminary Results

D’Annibale, Annibale; Pende, Vito; Pernazza, Graziano; Mikaelian, Igor; Mazzocchi, Paolo; Lucandri, Giorgio; Morpurgo, Emilio; Contardo, Tania; Sovernigo, Gianna

doi:10.1016/j.jss.2010.11.881

Cited by 93 publications

(72 citation statements)

References 56 publications

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“…surgery [2,25]. However, the future application of robot-assisted surgery for uterine cancer may be difficult when it includes complete resection of LVs along the uterine artery and superficial uterine vein, due to the tight nature of the connective sheath.…”

Section: Discussionmentioning

confidence: 99%

Lymphatic vessels around the uterus: D2-40 (podoplandin) immunohistochemistry using elderly cadavers

Sasaki

Jin

Liu³

et al. 2016

Folia Morphol

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Section: Discussionmentioning

confidence: 99%

Lymphatic vessels around the uterus: D2-40 (podoplandin) immunohistochemistry using elderly cadavers

Sasaki

Jin

Liu³

et al. 2016

Folia Morphol

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“…Thus, from the initial experience, robotic surgery can be carried out safely if it is conducted by a surgeon experienced in laparoscopic surgery. The learning curve of robotic gastrectomy demonstrates a quicker adaptation with most studies reporting 11‐25 cases to be sufficient for experienced gastric cancer surgeons,20, 35, 36 whereas 40‐60 cases of surgical experience are required to overcome the learning curves associated with laparoscopic gastrectomy 37, 38. However, there is no study directly comparing the learning curve effect of robotic surgery in cases of surgeons having no laparoscopic experience.…”

Section: Perioperative Outcomesmentioning

confidence: 99%

Robotic gastrectomy for gastric cancer: Current evidence

Alhossaini

Altamran

Seo

et al. 2017

Annals of Gastroent Surgery

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The robotic system has gained wide acceptance in specialties such as urological and gynecological surgery. It has also been applied in the field of upper gastrointestinal surgery. Since the first implementation of the robotic system for the treatment of gastric adenocarcinoma, the procedure has been found to be safe and feasible. Although robotic gastrectomy does not meet our expectations and yield better results than laparoscopic gastrectomy, this procedure seems to provide several advantages over laparoscopy such as reduced blood loss, shorter learning curves and increased number of retrieved lymph nodes. However, as many case series, including a recent multicenter study, have revealed, higher cost and longer operation time are the major limitations of robotic gastrectomy. Furthermore, there are no results from well‐designed randomized clinical trials comparing the two procedures. New procedures in much more technically demanding cases will test the genuine benefits of robotic gastrectomy.

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“…57,[64][65][66] Nevertheless, it has been reported in several studies that digestive restoration was performed extracorporeally through the same mini laparotomy used for specimen removal. 59,67 This hybrid-open technique was used both in gastrojejunostomy and gastroduodenostomy following distal gastrectomy, as well as in esophagojejunostomy following total gastrectomy, but had less reproducible results in Western patients with higher fat mass.…”

mentioning

confidence: 99%

“…59,70 Both setup time and operative time, together with the delay caused by instrument changes, are expected to decrease as the experience of the surgical and nursing teams increases. 11,64,[69][70][71] In comparative studies among OG, LG, and RAG, some authors 63,72 have reported that the estimated blood loss in the robotic group was significantly lower than in the open and laparoscopic groups. Similar results were confirmed in the meta-analysis from Xiong et al, 61 whose data appear to confirm the ability of surgeons to better control bleeding when using the robotic system, compared to conventional laparoscopy.…”

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confidence: 99%

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Gastrointestinal robotic surgery: challenges and developments

Becchini¹,

Annecchiarico²,

Marino³

et al. 2015

RSRR

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Abstract:The rapid diffusion of new technologies in surgery, together with high expectations of both patients and the mass media, has led to many gastrointestinal procedures being approached using robots. Robotic technology seems to resolve many of the drawbacks of laparoscopic advanced procedures, such as anastomotic reconstructions, accurate lymphadenectomy, and vascular sutures. In addition, a deeper tridimensional steady vision with excellent high definition, the EndoWrist technology offering seven degrees of freedom, tremor filtration, scaled motion, optimal working ergonomics, and avoidance of the 'fulcrum effect', are the main strengths of the da Vinci ® system. The use of near-infrared technology and the possibility of tutoring through a double-console will most likely add many more advantages of this technology over laparoscopy alone. However, none of the gastrointestinal robotic interventions has reached a level of evidence-based efficacy that enables it to be routinely applied. The main limitations of robotic gastrointestinal procedures are represented by the learning curve, the higher costs of robotic surgery compared to traditional and laparoscopic surgery, and the longer operation times, including setup and organizational troubles. Moreover, while the limits of robotics for benign diseases are mainly represented by technical issues, oncologic outcomes remain the foundation of any procedures to cure malignancies, and long-term follow-up is still lacking. On the other hand, a word of caution should be presented on the adoption of robotics in too many surgical units without the correct and formal technical background and third-party control to guarantee the best outcomes for patients at minimum risk. Therefore, the robotic treatment of gastrointestinal diseases requires a thorough analysis of the published evidence, in order to determine the correct indications and patient selection. This review aims to examine the evidence for the use of robotic surgery in both malignancies and benign disease arising from the gastrointestinal area. Future developments in robotics and ongoing areas of research are also analyzed.

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Full Robotic Gastrectomy with Extended (D2) Lymphadenectomy for Gastric Cancer: Surgical Technique and Preliminary Results

Cited by 93 publications

References 56 publications

Lymphatic vessels around the uterus: D2-40 (podoplandin) immunohistochemistry using elderly cadavers

Lymphatic vessels around the uterus: D2-40 (podoplandin) immunohistochemistry using elderly cadavers

Robotic gastrectomy for gastric cancer: Current evidence

Gastrointestinal robotic surgery: challenges and developments

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