Page 19 - WJOLS - Journal of Laparoscopic Surgery

Abhay Singhal et al
able to attain a three-dimensional surgical view enabling gastrectomy for distal gastric cancer: five-year results of a ran-
®
depth perception, the EndoWrist technology which allows domized prospective trial. Ann Surg 2005 Feb;241(2):232-237.
for seven degrees of freedom, tremor suppression and filtra- 5. Kim HH, Hyung WJ, Cho GS, Kim MC, Han SU, Kim W,
Ryu SW, Lee HJ, Song KY. Morbidity and mortality of lapa-
tion, and improved ergonomics. 10-13 Additionally, images roscopic gastrectomy versus open gastrectomy for gastric
can be enlarged enabling the performance of delicate steps, cancer: an interim report–a phase III multicenter, prospective,
such as lymph node dissection along great vessels which randomized Trial (KLASS Trial). Ann Surg 2010 Mar;251(3):
are essential in achieving a D2 dissection, suturing, or knot- 417-420.
ting. These features could enable the performance of rela- 6. Kodera Y, Fujiwara M, Ohashi N, Nakayama G, Koike M,
tively complicated procedures, such as function-preserving Morita S, Nakao A. Laparoscopic surgery for gastric cancer:
a collective review with metaanalysis of randomized trials.
gastrectomy or extended resections for advanced gastric J Am Coll Surg 2010 Nov;211(5):677-686.
cancer using a minimally invasive method. 23 7. Ding J, Liao GQ, Liu HL, Tang J. Meta-analysis of laparoscopy-
Encouraging results are being published using the assisted distal gastrectomy with D2 lymph node dissection
robotic technique, but the lack of homogeneous study for gastric cancer. J Surg Oncol 2012 Mar;105(3):297-303.
groups in terms of staging, comorbidities, and adjuvant 8. Yamamoto M, Rashid OM, Wong J. Surgical management of
gastric cancer: the East vs West perspective. J Gastrointest
and neoadjuvant therapies makes it hard to establish a Oncol 2015 Feb;6(1):79-88.
clear indication for RG in gastric cancer. Carefully weigh- 9. Kim MC, Jung GJ, Kim HH. Learning curve of laparoscopy-
ing the treatment options is especially important since assisted distal gastrectomy with systemic lymphadenec-
there are more and more groups publishing acceptable tomy for early gastric cancer. World J Gastroenterol 2005
results with the robotic technique. Dec;11(47):7508-7511.
Nonetheless, there are a series of shortcomings of the 10. Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH.
Robot-assisted gastrectomy with lymph node dissection for
robotic platform explaining this situation. First of all, the gastric cancer: lessons learned from an initial 100 consecutive
lack of robotic staplers and robotic seal and cut devices, procedures. Ann Surg 2009 Jun;249(6):927-932.
such as LigaSure™ is a considerable inconvenience. 11. Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH. Role
Second, due to the costs and duration of the procedures, of robotic gastrectomy using da Vinci system compared with
the robotic platform cannot be used to cover the whole laparoscopic gastrectomy: initial experience of 20 consecutive
cases. Surg Endosc 2009 Jun;23(6):1204-1211.
spectrum of procedures normally performed by a general 12. Hashizume M, Sugimachi K. Robot-assisted gastric surgery.
surgeon. 21 Surg Clin North Am 2003 Dec;83(6):1429-1444.
13. Kakeji Y, Konishi K, Ieiri S, Yasunaga T, Nakamoto M, Tanoue K,
CONCLUSION Baba H, Maehara Y, Hashizume M. Robotic laparoscopic
distal gastrectomy: a comparison of the da Vinci and Zeus
Within the limitation of a small-sized, nonrandomized systems. Int J Med Robot 2006 Dec;2(4):299-304.
analysis, our study confirms that robot-assisted gastrec- 14. Procopiuc L, Tudor Ş, Mănuc M, Diculescu M, Vasilescu C.
tomy is a feasible and safe surgical procedure. When Robot-assisted surgery for gastric cancer. World J Gastrointest
compared with conventional laparoscopy, robotic surgery Oncol 2016 Jan;8(1):8-17.
shows evident benefits in performing lymphadenectomy 15. Cianchi F, Indennitate G, Trallori G, Ortolani M, Paoli B,
with a higher number of retrieved and examined lymph Macrì G, Lami G, Mallardi B, Badii B, Staderini F, et al.
Robotic vs laparoscopic distal gastrectomy with D2 lymph-
nodes, and also the use of robotics is a good option for adenectomy for gastric cancer: a retrospective comparative
the upcoming surgeons since only less than 10 cases of monoinstitutional study. BMC Surg 2016 Sep;16:65.
robotic surgery are needed to become proficient in gastric 16. Parisi A, Reim D, Borghi F, Nguyen NT, Qi F, Coratti A,
cancer surgery. Cianchi F, Cesari M, Bazzocchi F, Alimoglu O, et al. Mini-
mally invasive surgery for gastric cancer: a comparison
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