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Updated: Jun 22, 2025
Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
Gastrointestinal Stromal Tumors of the Stomach: Is There Any Advantage of Robotic Resections? A Systematic Review and
Carlo Alberto Schena1, Andrea-Pierre Luzzi2, Vito Laterza3
1Unit of Robotic and Minimally Invasive Digestive Surgery, Department of Surgery, Ferrara University Hospital Arcispedale Sant'Anna, Ferrara, Italy.
Abstract:
The role of robotic surgery for gastrointestinal stromal tumor (GIST) resection remains unclear. This systematic review and meta-analysis aimed to investigate the outcomes of robotic versus laparoscopic surgery in patients requiring surgery for gastric GISTs. MEDLINE, EMBASE, and the Cochrane databases were searched from inception to September 4, 2023. Two independent reviewers conducted a systematic review of the literature to select all types of analytic studies comparing robotic versus laparoscopic surgery for GISTs and reporting intraoperative, postoperative, and/or pathological outcomes. Overall, 4 retrospective studies were selected, including a total of 264 patients, specifically 111 (42%) in the robotic and 153 (58%) in the laparoscopic group. Robotic surgery was associated with longer operating time (+42.46 min; 95% confidence interval [CI]: 9.34, 75.58; P=0.01; I2: 85%) and reduced use of mechanical staplers (odds ratio [OR]: 0.05; 95%CI: 0.02, 0.11; P<0.00001; I2: 92%;) compared with laparoscopy. Although nonsignificant, conversion to open surgery was less frequently reported for robotic surgery (2.7%) than laparoscopy (5.2%) (OR: 0.59; 95%CI: 0.17, 2.03; P=0.4; I2: 0%). No difference was found for postoperative and oncological outcomes. Robotic surgery for gastric GISTs provides similar intraoperative, postoperative, and pathological outcomes to laparoscopy, despite longer operative time.
Insights
Robotic surgery for gastric GIST resection offers similar outcomes to laparoscopic surgery. While robotic procedures take longer, they reduce stapler use and show a trend toward fewer open conversions.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- The role of robotic surgery in resecting gastrointestinal stromal tumors (GISTs) requires further clarification.
- This study systematically reviews and meta-analyzes outcomes of robotic versus laparoscopic surgery for gastric GISTs.
Approach:
- A comprehensive search of MEDLINE, EMBASE, and Cochrane databases was performed up to September 4, 2023.
- Two independent reviewers selected retrospective studies comparing robotic and laparoscopic approaches for GIST resection.
- Intraoperative, postoperative, and pathological outcomes were analyzed.
Key Points:
- Robotic surgery for gastric GISTs was associated with a significantly longer operative time (+42.46 min) and reduced mechanical stapler use compared to laparoscopy.
- Conversion to open surgery was less frequent in the robotic group (2.7%) versus the laparoscopic group (5.2%), though this difference was not statistically significant.
- No significant differences were observed in postoperative recovery or oncological outcomes between the two surgical methods.
Conclusions:
- Robotic surgery for gastric GIST resection yields comparable intraoperative, postoperative, and pathological results to laparoscopy.
- Despite a longer operative time, robotic surgery may offer benefits such as reduced stapler use and a potential decrease in open conversions.
