Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: comparison of surgical performance and short-term outcomes

Jun, Zhou; Shi, Yan; Tang, Bo; Hao, Ya; Zeng, Da‐Wu; Zhao, Yongliang; Qian, Feng; Yu, Peiwu

doi:10.1007/s00464-013-3385-6

Cited by 123 publications

(95 citation statements)

References 28 publications

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“…The author hypothesized that this was due to the surgeon's competence in laparoscopy and to some limits in robotic surgery, including the absence of tactile feedback and lack of various robotic instruments such as a suction-irrigator and endo-staplers. On the other hand, a number of retrospective studies [12,13] reported a significantly lower estimated blood loss during RAG than during laparoscopic and open surgery, as confirmed in several meta-analyses [1,15,21,28,30]. The use of robotics seems to reduce blood loss even in major and complex surgical procedures, because it allows for an extremely accurate and clean dissection especially during difficult procedures such as extended lymphadenectomies.…”

Section: Perioperative Outcomesmentioning

confidence: 95%

Robot-assisted gastrectomy for cancer

Bonapasta

Guerra

Linari

et al. 2016

Chirurg

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Section: Perioperative Outcomesmentioning

confidence: 95%

Robot-assisted gastrectomy for cancer

Bonapasta

Guerra

Linari

et al. 2016

Chirurg

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“…On the contrary, robotic surgery shows comparable or better retrieval of lymph nodes than laparoscopy (16,17,19,21,23,25). The reduced number of retrieved lymph nodes is the one single weakness of laparoscopic surgery, compared with open surgery, for which robotic systems can compensate.…”

Section: Higher Number Of Retrieved Lymph Nodesmentioning

confidence: 99%

“…In robotic gastrectomy, about half of all publications report less bleeding than that in laparoscopic surgery (7,17,20,(23)(24)(25)(26)(27)(28). Statistically, less bleeding may have no impact on the clinical course of the patients; however, it implies that robots offer more precise dissection of the lymph nodes following the surgical plane.…”

Section: Less Bleedingmentioning

confidence: 99%

Robotic surgery for gastric tumor: current status and new approaches

Lim

Lee

Son

et al. 2016

Transl. Gastroenterol. Hepatol.

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Surgical techniques have evolved tremendously over this past century. To maximize the efficacy and minimize the invasiveness of laparoscopic surgery, researchers have sought to implement wider application of robotics. Nevertheless, both optimism without sound evidence and fear of new technology obscure the appropriate uses of robotic surgery. In the present review, we attempted to provide a balanced perspective on the current state of robotic gastrectomy, outlining evidence and opportunities for the use thereof. Although evidence is limited, the use of robotics is feasible for gastric cancer surgery, and less than 10 cases of robotic surgery are needed to become proficient therein. Compared to the clinical impact of laparoscopy on gastric cancer surgery, the additional benefits of robotic surgery to patients seem to be limited. Despite additional costs and longer surgeries, robotic surgery reportedly does not offer surgical outcomes superior to those for laparoscopic surgery, according to a recent multicenter study.Meanwhile, however, our in-depth review of retrospective and prospective reports revealed that robots could expand the indications of minimally invasive gastrectomy for patients requiring total gastrectomy and D2 lymph node dissection. Moreover, we found that robotic gastrectomy is associated with a higher number of retrieved lymph nodes, less bleeding, fewer complications, and shorter hospital stay, compared to laparoscopic gastrectomy. Accordingly, new surgical approaches using advanced technologies, such as near infrared detectors, the Tilepro ® multi-input display, dual consoles, and the Single-Site ® system, are under investigation. In conclusion, measuring the additional benefits of robotic over laparoscopic surgery would be difficult and clinically insignificant. Thus, developing new surgical procedures that extend the benefits of conventional laparoscopic surgery to patients in whom minimally invasive surgery would not be possible is necessary to justify the greater use of robotic surgery.

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“…As for tumor recurrence, it was 4.2% in the robotic and 7.1% in the laparoscopic group during a follow‐up period of 15 and 19 months, respectively 24. As for long‐term survival and recurrence, although some studies have shown it was similar for both laparoscopic and robotic surgery, longer follow‐up periods with larger sample size studies that include advanced gastric cancer patients are still required to determine the oncological efficacy of robotic surgery.…”

Section: Oncological 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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Robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: comparison of surgical performance and short-term outcomes

Cited by 123 publications

References 28 publications

Robot-assisted gastrectomy for cancer

Robot-assisted gastrectomy for cancer

Robotic surgery for gastric tumor: current status and new approaches

Robotic gastrectomy for gastric cancer: Current evidence

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