[Robot-Assisted Distal Gastrectomy for Gastric Cancer with Adachi Ⅵ Type Vascular Anomaly-A Case Report]

We report a case of vascular anomaly of Adachi type Ⅵ. The common hepatic artery does not appear at the superior edge of the pancreas in Adachi type Ⅵ. A 67-year-old woman was diagnosed with gastric cancer. Preoperative computed tomography showed the vascular anomaly. The patient was treated successfully with robot-assisted distal gastrectomy by the da Vinci Surgical System®(da Vinci). The postoperative course was uneventful and the patient was discharged 10 days after surgery. The vascular anomaly makes the dissection of lymph nodes No. 8a and 9, difficult. Owing to wristed instruments with several joints and 3D-HD visualization, the da Vinci is superior to conventional laparoscopic surgery in completing detailed and complex procedures. Therefore, the da Vinci is useful for performing an extremely challenging gastrectomy procedure, as in this case.