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Tokunaga et al. J Cancer Metastasis Treat 2018;4:40 Journal of Cancer
DOI: 10.20517/2394-4722.2017.80 Metastasis and Treatment

Review Open Access

Robotic gastrectomy for gastric cancer

Masanori Tokunaga, Masahiro Watanabe, Shizuki Sugita, Akiko Tonouchi, Akio Kaito, Takahiro Kinoshita

Gastric Cancer Division, National Cancer Center Hospital East, Kashiwa 277-8577, Japan.

Correspondence to: Dr. Masanori Tokunaga, Gastric Cancer Division, National Cancer Center Hospital East, 6-5-1 Kashiwanoha,
Kashiwa 277-8577, Japan. E-mail: mtokunag@east.ncc.go.jp

How to cite this article: Tokunaga M, Watanabe M, Sugita S, Tonouchi A, Kaito A, Kinoshita T. Robotic gastrectomy for gastric
cancer. J Cancer Metastasis Treat 2018;4:40. http://dx.doi.org/10.20517/2394-4722.2017.80

Received: 21 Nov 2017 First Decision: 23 Jan 2018 Revised: 13 Feb 2018 Accepted: 14 Jul 2018 Published: 30 Jul 2018
Science Editors: Lucio Miele, Masayuki Watanabe Copy Editor: Jun-Yao Li Production Editor: Cai-Hong Wang

Abstract
Robotic gastrectomy (RG) is increasingly performed, particularly in East Asia. With articulated devices, surgeons are able
to perform every procedure more comfortably and meticulously, which makes RG ideal from the surgeon’s standpoint.
However, it is still unclear whether it is a suitable treatment strategy from the patient’s viewpoint, due to the lack of solid
evidence obtained from randomized controlled trials. The feasibility of RG has been demonstrated in many retrospective
comparative studies, which showed similar trends, including relatively less estimated blood loss and longer operation
time with RG than laparoscopic gastrectomy (LG), equivalent number of harvested lymph nodes and similar length of
postoperative hospital stay between RG and LG. However, considering the higher medical expenses associated with RG,
its superiority in terms of long-term survival outcomes will need to be confirmed for it to be accepted more widely.

Keywords: da Vinci, robot, gastric cancer, robot assisted gastrectomy, laparoscopic gastrectomy

INTRODUCTION
Minimally invasive surgery (MIS) for gastric cancer has been increasingly performed in the East, where
incidence of the disease is high and approximately half of cases are diagnosed at an early stage . The
[1-3]
non-inferiority of laparoscopic gastrectomy (LG) for early gastric cancer comparing to open gastrectomy in
terms of short- and/or long-term outcomes has been confirmed by randomized controlled trials, and that
for advanced gastric cancer is under investigation and may be shown in the near future . However, LG has
[4-7]
several shortcomings which include limitation in the movement range of forceps and the two-dimensional
surgical view available to operating surgeons, and it will be necessary to overcome these issues for MIS to
be accepted more widely.

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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