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Updated: May 22, 2026
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Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
[Robotic gastrectomy after neoadjuvant therapy: application advantages and technical key points].
1Department of General Surgery, Division of Gastric Surgery, the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing 210029, China.
Summary
Neoadjuvant therapy for locally advanced gastric cancer causes difficult-to-operate fibrotic changes. Robotic surgery offers advantages over laparoscopy for these complex cases, improving lymph node dissection and patient outcomes.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Neoadjuvant therapy (NAT) is crucial for locally advanced gastric cancer (LAGC).
- NAT induces histopathological changes (fibrosis, edema, inflammation) complicating surgery.
- Minimally invasive surgical platforms and strategies are key considerations post-NAT.
Purpose of the Study:
- To review NAT-induced histopathological changes and their surgical implications in LAGC.
- To compare laparoscopic versus robotic surgery in the post-NAT setting.
- To provide guidance on surgical strategies, including instrument selection for minimally invasive procedures.
Main Methods:
- Systematic review combining literature and prospective study data.
- Comparative analysis of laparoscopic and robotic surgery platforms.
- Evaluation of energy devices (ultrasonic shears vs. Maryland forceps) for dissection in fibrotic tissue.
Main Results:
- Robotic surgery demonstrates advantages due to 3D vision, wristed instruments, and tremor filtration, particularly in fibrotic regions.
- Robotic surgery may enhance lymph node dissection and reduce postoperative inflammation.
- Maryland forceps are superior to ultrasonic shears for fine dissection in fibrotic areas, offering better nerve preservation and plane maintenance.
Conclusions:
- Robotic surgery presents significant benefits for minimally invasive procedures in post-NAT LAGC patients.
- Surgical strategy should prioritize D2 lymphadenectomy, ensuring oncological safety regardless of NAT.
- Careful instrument selection, like Maryland forceps, is vital for managing NAT-induced tissue changes effectively.
