Multicenter Prospective Comparative Study of Robotic Versus Laparoscopic Gastrectomy for Gastric Adenocarcinoma

Abstract

The use of robotic systems is assumed to provide a technically superior operative environment for minimally invasive surgery. However, our analysis of perioperative surgical outcomes indicated that robotic gastrectomy is not superior to laparoscopic gastrectomy. Clinical trials identification: NCT01309256.

Robotic gastrectomy for gastric cancer: Current evidence

“…A recent multicenter prospective comparative study showed similar overall complication rates of 11.9% in the robotic group and 10.3% in the laparoscopic group and the rate of major complications of 1.1% in both groups 29. So far, one publication has shown significantly fewer complications for robotic gastrectomy in comparison to laparoscopic gastrectomy regarding postoperative pancreatic fistula at a rate of 2.3% vs 11.4%, respectively.…”

“…A recent multicenter prospective comparative study also showed no difference in hospital stay between robotic and laparoscopic gastrectomy 29. However, a retrospective study demonstrated a reduction in hospital stay between the two approaches with a mean of 14 days in the robotic group and 15 days in the laparoscopic group 28.…”

“…Meanwhile, data from a recent multicenter non‐randomized comparative trial showed that there was no difference in estimated blood loss between robotic and laparoscopic gastrectomy 29. However, this should be further scrutinized, because there might be a certain group of patients (ie patients with higher body mass index or those who underwent extensive lymph node dissection) that benefit from the robotic procedure with less blood loss.…”

“…Although most of the operation costs for laparoscopic gastrectomy are covered by national insurance, none of the operation costs for robotic gastrectomy are covered. Thus, the actual cost charged to patients was US$7326 more for the robotic than for the laparoscopic group 29. However, to identify whether the cost of robotic surgery is higher than that of laparoscopic gastrectomy, more comprehensive analyses considering different insurance systems need to be carried out.…”

Ongoing surgical clinical trials on minimally invasive surgery for gastric cancer: Korea

“…Therefore, a prospective, multicenter comparative study was conducted in Korea and the short-term outcome was reported recently (NCT01309256). There were no significant differences in morbidity and mortality rates, estimated blood loss, rates of open conversion, diet build-up, and length of hospital stay, but significantly higher cost and longer operation time in robot group were observed as expected (42). Studies on the long-term surgical outcomes are on progress.…”