Initial Clinical Experience and Technical Insights in Single-Port Robotic Gastrectomy: A Consecutive Case Series...

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Single-port robotic gastrectomy (SPRG) is an emerging technique with limited evidence on safety and feasibility.
• This study evaluates early outcomes of single-port robotic distal gastrectomy (spRDG) for gastric cancer.

Purpose of the Study:

• To assess the safety, feasibility, and oncologic outcomes of spRDG.
• To provide technical insights for implementing this technique.

Main Methods:

• Nine patients with resectable gastric cancer underwent spRDG using a subumbilical approach.
• Procedures included lymphadenectomy (D1+ or D2) and intracorporeal reconstruction (Billroth I, II, or Roux-en-Y).
• Perioperative variables, pathology, and textbook outcomes (TO) were assessed.

Main Results:

• All spRDG procedures were completed successfully without conversion.
• R0 resection was achieved in all patients, with a mean of 30.2 lymph nodes retrieved.
• Textbook outcomes were achieved in 88.9% of patients; one failure was due to unrelated postoperative complications.

Conclusions:

• spRDG is a feasible, safe, and oncologically sound option for selected gastric cancer patients.
• Successful implementation requires proficiency with the da Vinci SP system's ergonomics and workflow.
• Current indications should be limited to distal gastrectomy with D1+ lymphadenectomy pending larger studies.