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Updated: Dec 19, 2025
Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
Robotic surgery for gastric gastrointestinal stromal tumors: A single center case series
Alec Winder1, Dirk C Strauss1, Robin L Jones1
1Department of Academic Surgery, Sarcoma, Melanoma and Rare Tumours Unit, The Royal Marsden Hospital, London, UK.
Background And Objectives:
The 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.
Methods:
GIST 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.
Results:
Robotic 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).
Conclusions:
Robotic resection of gastric GIST's appears oncologically safe, and may expand the benefits of MIS to a greater cohort of complex cases.
Insights
Robotic resection of challenging gastric gastrointestinal stromal tumors (GISTs) is safe and effective. This minimally invasive surgery (MIS) approach expands treatment options for complex GIST cases, achieving complete tumor removal with no complications.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Robotic Surgery
Background:
- Microscopically complete resection is the goal for gastrointestinal stromal tumors (GIST).
- Minimally invasive surgery (MIS) for GISTs was initially limited to smaller, favorably located tumors.
- Concerns persist regarding MIS for larger or complex-location GISTs.
Purpose of the Study:
- To evaluate the effectiveness of robotic resection for challenging gastric GISTs.
- To assess the oncological safety and feasibility of robotic surgery in complex GIST cases.
Main Methods:
- Robotic resections were performed using the Intuitive Da Vinci Surgical Xi System.
- Challenging GISTs were defined by size (>50 mm) and/or location (Privette/Al-Thanai types II-IV).
- 12 consecutive patients with gastric GISTs underwent robotic resection.
Main Results:
- 83% of resections (10/12) were for challenging GISTs (size and/or location).
- All tumors achieved clear margins (R0) via wedge resection without complications.
- Median operative time was 192 minutes, with a median hospital stay of 2 days.
Conclusions:
- Robotic resection is an oncologically safe method for gastric GISTs.
- This approach broadens the applicability of MIS to more complex GIST cases.
- Robotic surgery offers a viable option for challenging GIST resections.
