4.4 Review

Current status of robotic gastrectomy for gastric cancer: comparison with laparoscopic gastrectomy

Journal

UPDATES IN SURGERY
Volume 73, Issue 3, Pages 853-863

Publisher

SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s13304-020-00958-5

Keywords

Robotic gastrectomy; Gastric cancer; Operative outcomes; Oncologic outcomes

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Funding

  1. Covidien Private Limited (Medtronic) [ISR-2017-10924]

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Robotic gastrectomy is increasingly used for gastric cancer treatment with advantages such as longer operation time and less blood loss. Studies have shown comparable long-term oncological outcomes between robotic and laparoscopic gastrectomy, indicating robotic gastrectomy is a safe procedure. However, high cost remains a major barrier for robotic surgery to become a routine treatment for gastric cancer patients.
Robotic systems were developed to overcome limitations of laparoscopic surgery with its mechanical advantages. Along with the technical advances, robotic gastrectomy for gastric cancer is increasing. However, the evidence regarding safety and efficacy for robotic gastrectomy for gastric cancer is not mature yet. Although studies are limited, it is evident that robotic gastrectomy has a longer operation and less blood loss compared with laparoscopic gastrectomy. Studies revealed long-term oncological outcomes after robotic gastrectomy was comparable to those after laparoscopic gastrectomy. Taken together, robotic gastrectomy with systemic lymph node dissection is suggested as a safe procedure with equivalent short- and long-term oncologic outcomes to either laparoscopic or open gastrectomy for the surgical treatment of gastric cancer. However, high cost is the most significant barrier to justify robotic surgery as a routine and standard treatment for patients with gastric cancer. In the meanwhile, robotic surgery will be expansively used as long as technologic developments continue.

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