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Robot-assisted gastrectomy for cancer.

N C Buchs¹, P Bucher, F Pugin

¹Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland. nicolas.c.buchs@hcuge.ch

Minerva Gastroenterologica E Dietologica

|March 5, 2011

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Robot-assisted gastrectomy (RAG) for cancer is feasible and appears safe, with low mortality and acceptable morbidity. However, more research with long-term follow-up is needed before RAG can be widely recommended for gastric cancer surgery.

Area of Science:

Surgical Oncology
Minimally Invasive Surgery
Robotic Surgery

Background:

Minimally invasive surgery for gastric cancer is increasingly accepted.
The da Vinci robotic system enhances laparoscopic capabilities.
Robot-assisted gastrectomy (RAG) feasibility has been reported in several studies.

Purpose of the Study:

To conduct a systematic review of published literature on robot-assisted gastrectomy for gastric cancer.
To assess the value and outcomes of RAG in oncologic gastrectomy.

Main Methods:

Systematic literature review of studies on RAG for gastric cancer published since 2003.
Analysis of 10 original studies reporting 199 RAG procedures.
Evaluation of operative time, blood loss, conversion rate, lymph node retrieval, complications, mortality, and hospital stay.

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Main Results:

Mean operative times: 265 min (total), 334 min (subtotal).
Mean blood loss: 113 mL; Conversion rate: 2.5%; Lymph nodes retrieved: 32.
Complications: 14.6%; Mortality rate: 1.5%; Mean hospital stay: 10 days.

Conclusions:

Robot-assisted gastrectomy for gastric cancer is feasible and demonstrates safety with low mortality and acceptable morbidity.
The limited number of studies and lack of long-term follow-up preclude definitive conclusions.
Randomized controlled trials with extended follow-up are necessary to generalize the use of RAG for oncologic gastrectomy.