Related Experiment Video
Updated: Jan 19, 2026
Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
Effect of Surgical Approach on Node Harvest in Robotic Gastrectomy
Abstract:
There has been increasing utilization of minimally invasive surgical approaches. This study evaluates the effect of surgical approach on total lymph node harvest in gastrectomy. Patients undergoing gastrectomy for gastric adenocarcinoma between 2007 and 2018 were reviewed retrospectively. Data collected included age, gender, race, BMI, neoadjuvant therapy, tumor stage, surgical approach, and total number of lymph nodes harvested. The total number of harvested lymph nodes for open, laparoscopic, and robotic gastrectomy was compared using the Kruskal-Wallis test for univariate analysis and a Poisson regression model for multivariable analysis. One hundred four patients were identified. Median node harvest for open, laparoscopic, and robotic approaches were 16, 17, and 36, respectively. Multivariable analysis controlling for gender, BMI, pathological T stage, and year of operation demonstrates that surgical approach is statistically significantly associated with lymph node harvest (F = 83.4, P < 0.0001). In multivariable analysis, robotic approach was associated with greater lymph node harvest than both open (P < 0.0001) and laparoscopic (P < 0.0001) approaches, whereas laparoscopic approach was associated with greater lymph node harvest than open (P < 0.0001) approach. These data demonstrate that for patients undergoing gastrectomy for gastric adenocarcinoma at our institution, robotic approach is associated with greater lymph node harvest than both laparoscopic and open approaches.
Insights
Robotic gastrectomy significantly increases lymph node harvest compared to open and laparoscopic approaches. This minimally invasive technique improves staging accuracy for gastric adenocarcinoma patients.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Minimally invasive surgical techniques are increasingly adopted in gastrointestinal surgery.
- Lymph node harvest is a critical factor for accurate staging in gastric adenocarcinoma.
Purpose of the Study:
- To evaluate the impact of surgical approach (open, laparoscopic, robotic) on the total number of lymph nodes harvested during gastrectomy for gastric adenocarcinoma.
Main Methods:
- Retrospective review of 104 patients who underwent gastrectomy for gastric adenocarcinoma between 2007 and 2018.
- Comparison of lymph node yield across open, laparoscopic, and robotic approaches using Kruskal-Wallis and Poisson regression analyses.
- Multivariable analysis controlled for patient demographics, tumor stage, and operative year.
Main Results:
- Median lymph node harvest was 16 for open, 17 for laparoscopic, and 36 for robotic gastrectomy.
- Robotic approach was associated with significantly higher lymph node yield than both open (P < 0.0001) and laparoscopic (P < 0.0001) methods.
- Laparoscopic approach also yielded more lymph nodes than open surgery (P < 0.0001).
Conclusions:
- Surgical approach significantly influences lymph node harvest in gastrectomy for gastric adenocarcinoma.
- Robotic-assisted gastrectomy is associated with superior lymph node retrieval compared to laparoscopic and open techniques.
- Enhanced lymph node harvest may improve pathological staging and subsequent treatment decisions.
