Optimising Robotic Radical Gastrectomy: A Technical Roadmap for Bipolar Forceps-Assisted Lymphadenectomy and...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robotic surgery offers enhanced precision and ergonomics compared to laparoscopy.
• Optimal robotic surgery requires adapting techniques to the platform and overcoming laparoscopic habits.
• This report focuses on a novel approach to robotic gastrectomy, emphasizing instrument selection and lymphadenectomy.

Purpose of the Study:

• To present a refined technique for robotic gastrectomy.
• To detail innovations in instrument selection and lymphadenectomy for robotic surgery.
• To facilitate the transition from laparoscopic to robotic surgical practices.

Main Methods:

• Utilized Maryland bipolar forceps for lymphadenectomy.
• Implemented a robotic-specific lymphadenectomy sequence prioritizing gravity-assisted exposure.
• Performed intracorporeal hand-suturing for anastomosis to reduce stapler use.

Main Results:

• Maryland bipolar forceps demonstrated safer dissection with lower thermal injury risk.
• The novel lymphadenectomy sequence improved surgical field consolidation and reduced instrument repositioning.
• Robotic suturing ensured satisfactory anastomotic integrity.

Conclusions:

• A deliberate shift from laparoscopic to robotic techniques enhances outcomes in robotic surgery.
• The presented framework can accelerate the learning curve for surgeons new to robotic procedures.
• This approach optimizes the utilization of robotic platform capabilities in gastrectomy.