Robotic Gastrectomy: Technique Standardization

Dias, André Roncon; Ramos, Marcus Fernando Kodama Pertille; Szor, Daniel José; Abdalla, René Jorge; Barchi, Leandro Cardoso; Yagi, Osmar Kenji; Ribeiro, Ulysses; Zilberstein, Bruno; Cecconello, Ivan

doi:10.1590/0102-672020200003e1542

Cited by 4 publications

(1 citation statement)

References 13 publications

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“…В отличие от зарубежных коллег, которые используют до семи роботических инструментов, нами разработан и оптимизирован процесс выполнения гастрэктомии и дистальной субтотальной резекции желудка с применением четырех роботических инструментов, что позволяет максимально стандартизировать методику и снизить финансовые затраты [8]. При выполнении оперативных вмешательств мы не используем роботический гармонический скальпель, в отличие от бразильских коллег, считая, что данный инструмент не имеет преимуществ по причине своих конструктивных особенностей [9]. При оперативных вмешательствах используются инструменты: Large Needle Driver, Fenestrated Bipolar Forceps, Monopolar Curved Scissors, ProGrasp Forceps.…”

Section: техника операцийunclassified

Robot-assisted stomach cancer surgery. Technical aspects

Kovalenko,

Gladyshev,

Moiseev

et al. 2023

Russian Medical Inquiry

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Stomach cancer surgery remains one of the most technically challenging areas in abdominal oncology. The frequency of both intra- and postoperative complications is quite high, despite the modern achievements of anesthesiology and the technical support level. Robot-assisted surgical interventions allow to demonstrate all the benefits of minimally invasive technologies for the patient. Additional security is provided by the control of the video system and robotic instruments by one surgeon. The technical features of the robotic complex can be implemented in reducing the frequency of intra- and postoperative complications and improving the quality of surgical intervention, lymphadenectomy, as well as oncological results. The authors present their methodology for conducting surgical interventions in stomach cancer using a robotic surgical complex. Unlike foreign colleagues who use up to seven robotic instruments, the process of performing gastrectomy and subtotal gastrectomy using four robotic instruments has been developed and optimized, which allows to standardize the technique to the extent possible and reduce financial costs. The technique of using indocyanine green with the possibility of visualization in the infrared spectrum of its accumulation in lymph nodes, which are pathways of lymphogenic metastasis, is described. This can improve the accuracy of staging, determine forecast. KEYWORDS: robot-assisted surgery, stomach cancer, oncology, gastric resection, gastrectomy. FOR CITATION: Kovalenko S.A., Gladyshev D.V., Moiseev M.E. et al. Robot-assisted stomach cancer surgery. Technical aspects. Russian Medical Inquiry. 2023;7(4):218–224 (in Russ.). DOI: 10.32364/2587-6821-2023-7-4-218-224.

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Section: техника операцийunclassified

Robot-assisted stomach cancer surgery. Technical aspects

Kovalenko,

Gladyshev,

Moiseev

et al. 2023

Russian Medical Inquiry

View full text Add to dashboard Cite

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Robotic versus laparoscopic gastrectomy for gastric cancer: A Western propensity score matched analysis

Dias,

Pereira,

Ramos

et al. 2024

Journal of Surgical Oncology

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BackgroundRobot‐assisted gastrectomy (RG) has been shown to be safe and feasible in the treatment of gastric cancer (GC). However, it is unclear whether RG is equivalent to laparoscopic gastrectomy (LG), especially in the Western world. Our objective was to compare the outcomes of RG and LG in GC patients.MethodsWe reviewed all gastric adenocarcinoma patients who underwent curative gastrectomy by minimally invasive approach in our institution from 2009 to 2022. Propensity score matching (PSM) analysis was conducted to reduce selection bias. DaVinci Si platform was used for RG.ResultsA total of 156 patients were eligible for inclusion (48 RG and 108 LG). Total gastrectomy was performed in 21.3% and 25% of cases in LG and RG, respectively. The frequency of stage pTNM II/III was 48.1%, and 54.2% in the LG and RG groups (p = 0.488). After PSM, 48 patients were matched in each group. LG and RG had a similar number of dissected lymph nodes (p = 0.759), operative time (p = 0.421), and hospital stay (p = 0.353). Blood loss was lower in the RG group (p = 0.042). The major postoperative complications rate was 16.7% for LG and 6.2% for RG (p = 0.109). The 30‐day mortality rate was 2.1% and 0% for LG and RG, respectively (p = 1.0). There was no significant difference between the LG and RG groups for disease‐free survival (79.6% vs. 61.2%, respectively; p = 0.155) and overall survival (75.9% vs. 65.7%, respectively; p = 0.422).ConclusionRG had similar surgical and long‐term outcomes compared to LG, with less blood loss observed in RG.

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