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Related Experiment Video

Updated: Sep 16, 2025

Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
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Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection

Published on: February 7, 2025

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Risk of Open Conversion During Robotic Gastrectomy for Gastric Cancer: Optimizing Patient Selection.

Courtney Chen1,2, Tiffany Lim2, Annie Yang1

  • 1Division of Surgical Oncology, Department of Surgery, City of Hope Comprehensive Cancer Center, Duarte, California, USA.

Journal of Surgical Oncology
|July 10, 2025
PubMed
Summary
This summary is machine-generated.

Robotic gastrectomy for gastric cancer has benefits, but open conversion is a risk. Preoperative EUS and prior surgeries influence conversion rates, guiding better patient selection for robotic surgery.

Keywords:
advanced gastric cancerendoscopic ultrasoundopen conversionrobotic gastrectomy

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Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Robotic Surgery

Background:

  • Robotic surgery (RG) offers recovery advantages for gastric adenocarcinoma (GC) over open and laparoscopic methods.
  • Open conversion (OC) during RG is linked to poorer patient outcomes, but factors influencing it are not well understood.

Purpose of the Study:

  • To identify preoperative and intraoperative risk factors for open conversion (OC) during robotic gastrectomy (RG).
  • To analyze the outcomes associated with OC in robotic gastrectomy for GC.

Main Methods:

  • Retrospective analysis of 133 robotic gastrectomies for GC from a US cancer center database (2010-2022).
  • Inclusion criteria: radical resection for biopsy-proven GC initiated robotically.
  • Identification of preoperative risk factors and intraoperative reasons for OC.

Main Results:

  • The OC rate decreased from 42.1% before RG standardization to 15.8% after standardization.
  • Key intraoperative reasons for OC included tumor invasion/fibrosis (38.5%) and bulky nodes (26.9%).
  • Preoperative endoscopic ultrasound (EUS) decreased OC likelihood (OR 0.78), while prior abdominal surgeries increased it (OR 1.31).

Conclusions:

  • Preoperatively identifiable factors, such as EUS findings and surgical history, can guide patient selection for RG.
  • Intraoperative challenges necessitate improved preoperative assessment and planning to minimize OC in robotic gastrectomy.