Robotic surgery for gastric gastrointestinal stromal tumors: A single center case series

Abstract

Background and ObjectivesThe aim of surgical treatment of gastrointestinal stromal tumors (GIST) is a microscopically complete resection. Initial indications for laparoscopic surgery were limited to smaller tumors, in favorable locations. Over time, indications for minimal invasive surgery (MIS) have expanded, however concerns remain when considering resection of larger GISTs. Our aims were to assess the utility of robotic resection of gastric GISTs for challenging tumors.MethodsGIST resections, in this study were performed using the Intuitive Da Vinci Surgical Xi System. GIST's were considered challenging if tumor size was >50 mm at the time of surgery and/or the location of the tumor was type II, III, or IV using Privette/Al‐Thanai classification.ResultsRobotic resections were performed on 12 consecutive patients, 83% were considered challenging cases, 6 out of 12 for location and 5 out of 12 for size. Initial median tumor size on imaging was 53.7 mm, and post‐imatinib was 45.8 mm. All tumors were removed with clear margins (R0) via wedge resections, with no complications. Median operative time was 192 minutes (95‐250). Length of hospital stay was 2 days (2‐6).ConclusionsRobotic resection of gastric GIST's appears oncologically safe, and may expand the benefits of MIS to a greater cohort of complex cases.

Robotic-assisted surgery for esophageal submucosal tumors: a single-center case series

“…In literature, the safety and feasibility of the robotic approach of mesenchymal tumors has recently been described for the treatment of gastric GIST in unfavorable locations by Arseneaux [ 31 ] and Winder [ 32 ], showing optimal surgical and oncological outcomes. However, although with satisfactory results, the published experiences concerning the robotic approach to esophageal SMTs are limited to some case reports and only one case series (Table 4 ).…”

A narrative review of minimally invasive techniques for treatment of gastric gastrointestinal stromal tumors

“…This overcomes the limits of laparoscopy such as difficulty in instrument movement and 2D-vision. Robotic approach has a very undefined role in GIST surgery: in literature, studies about robotic approach for GISTs are very few, contrary to laparoscopic approach (33,34). Buchs et al (18) published the first robotic series of gastric GIST in 2010, who established the feasibility and the safety.…”

Application of Artificial Intelligence in Medicine: An Overview

“…This AI system revolutionized the traditional surgical model. For example, with the application of the Da Vinci surgical AI system, thyroid surgery was improved in terms of the postoperative cosmesis and voice outcomes [53] , maxillary surgery was improved in terms of the accuracy and safety [54] , gastric, nephritic, and prostatic surgery was improved as shown by the high surgical success rate but low complication rate [55][56][57] , and lung cancer surgery was beneficial to the patients in terms of the postoperative recovery [58] . Except for the above points of surgical operation enhancement, compared to traditional surgical systems, the most outstanding characteristic of AI surgical systems particularly lies in "AI", meaning that the surgical systems progressed from a nonintelligent form to an intelligent form.…”