J Gastric Cancer.  2013 Dec;13(4):255-262.

Emerging Role of Robot-assisted Gastrectomy: Analysis of Consecutive 200 Cases

• Park JY
• Kim YW
• Ryu KW
• Eom BW
• Yoon HM
• Reim D

Abstract

PURPOSE
Robotic surgery for gastric cancer is a promising alternative to laparoscopic surgery, but the data are limited. We aimed to evaluate whether gaining experience in robotic gastrectomy could improve surgical outcomes in the treatment of gastric cancer.
MATERIALS AND METHODS
Two hundred and seven consecutive cases of patients with clinical stage I gastric cancer who underwent robotic surgery at the National Cancer Center of Korea between February 2009 and February 2012 were retrospectively reviewed. Surgical outcomes were analyzed and compared between the initial 100 and later 100 cases.
RESULTS
Seven patients required conversion to open surgery and were excluded from further analysis. The mean operating time for all patients was 248.8 minutes, and mean length of hospitalization was 8.0 days. Twenty patients developed postoperative complications. Thirteen were managed conservatively, while 6 had major complications requiring invasive procedures. One mortality occurred owing to myocardial infarction. Operating time was significantly shorter in the latter 100 cases than in the initial 100 cases (269.9 versus 233.5 minutes, P<0.001). The number of retrieved lymph nodes was significantly greater in the latter cases (35.9 versus 39.9, P=0.032). The hospital stay of patients with complications was significantly longer in the initial cases than in the latter cases (16 versus 7 days, P=0.005).
CONCLUSIONS
Increased experience with the robotic procedure for gastric cancer was associated with improved outcomes, especially in operating time, lymph node retrieval, and shortened hospital stay of complicated patients. Further development of surgical techniques and technology might enhance the role of robotic surgery for gastric cancer.

Keyword

Stomach neoplasms; Minimally invasive surgical procedures; Robotics; Laparoscopy

MeSH Terms

Conversion to Open Surgery
Gastrectomy*
Hospitalization
Humans
Korea
Laparoscopy
Length of Stay
Lymph Nodes
Mortality
Myocardial Infarction
Postoperative Complications
Retrospective Studies
Robotics
Stomach Neoplasms
Surgical Procedures, Minimally Invasive

Figure

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  Fig. 1 Comparison of length of hospital stay between the initial and latter experience in complicated cases. Error bar depicts interquartile ranges (Mann-Whitney U test applied).

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  Fig. 2 Change in operating time. Operating time gradually decreased along with the accumulation of surgical experience. (A) Robot-assisted distal gastrectomy, (B) Robot-assisted total gastrectomy.

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