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Table 4. Compararison of postoperative morbidy and mortality
Author Year Country/area Approach Number of patients (n) Morbidity rate Mortality rate
Huang et al. [19] 2014 Taiwan LG vs. RG 73 vs. 35 a 8% vs. 13% 1.4% vs. 1.4%
Suda et al. [40] 2015 Japan LG vs. RG 438 vs. 88 a 11% vs. 2% 0.2% vs. 1.1%
Nakauchi et al. [17] 2016 Japan LG vs. RG 437 vs. 84 a 12% vs. 2% -
Yang et al. [43] 2017 Korea OG vs. LG vs. RG 241 vs. 511 vs. 173 a 25% vs. 12% vs. 5% 0.8% vs. 0.4% vs. 0%
Song et al. [9] 2009 Korea LDG (early) vs. RDG 20 vs. 20 5% vs. 5% 0% vs. 0%
LDG (later) vs. RDG 20 vs. 20 10% vs. 5% 0% vs. 0%
Kim et al. [30] 2010 Korea ODG vs. LDG vs. RDG 12 vs. 11 vs. 16 17% vs. 9% vs. 13% 0% vs. 0% vs. 0%
Caruso et al. [22] 2011 Italy OG vs. RG 120 vs. 29 43% vs. 41% 3.3% vs. 0%
Woo et al. [42] 2011 Korea LG vs. RG 591 vs. 236 14% vs. 11% 0.3% vs. 0.4%
Eom et al. [18] 2012 Korea LDG vs. RDG 62 vs. 30 7% vs. 13% 0% vs. 0%
Huang et al. [25] 2012 Korea OG vs. LG vs. RG 586 vs. 64 vs. 39 15% vs. 16% vs. 15% 1.4% vs. 1.6% vs. 2.6%
Kim et al. [29] 2012 Korea OG vs. LG vs. RG 4542 vs. 861 vs. 436 11% vs. 9% vs. 10% 0.5% vs. 0.3% vs. 0.5%
Park et al. [20] 2012 Korea LDG vs. RDG 120 vs. 30 8% vs. 17% 0% vs. 0%
Uyama et al. [41] 2012 Japan LDG vs. RDG 25 vs. 225 11% vs. 17% 0% vs. 0%
Yoon et al. [44] 2012 Korea LTG vs. RTG 65 vs. 36 15% vs. 17% 0% vs. 0%
Hyun et al. [26] 2013 Korea LG vs. RG 83 vs. 38 39% vs. 47% 0% vs. 0%
Junfeng et al. [27] 2014 America LG vs. RG 394 vs. 120 4% vs. 6% -
Kim et al. [28] 2014 Korea LDG vs. RDG 481 vs. 172 4% vs. 5% 0.6% vs. 0%
Noshiro et al. [33] 2014 Japan LDG vs. RDG 460 vs. 21 10% vs. 10% 0% vs. 0%
Son et al. [39] 2014 Korea LTG vs. RTG 58 vs. 51 22% vs. 16% 0% vs. 2.0%
Han et al. [24] 2015 Korea LPPG vs. RPPG 69 vs. 68 22% vs. 19% 0% vs. 0%
Lee et al. [32] 2015 Korea LDG vs. RDG 267 vs. 133 13% vs. 11% -
Seo et al. [37] 2015 Korea LDG vs. RDG 40 vs. 40 30% vs. 28% -
Park et al. [35] 2015 Korea LG vs. RG 622 vs. 148 8% vs. 8% 0.5% vs. 0%
Cianchi et al. [23] 2016 Italy LDG vs. RDG 41 vs. 30 12% vs. 13% 4.9% vs. 3.3%
Kim et al. [31] 2016 Korea LDG vs. RDG 288 vs. 87 9% vs. 6% 0.3% vs. 1.1%
Okumura et al. [34] 2016 Korea OG vs. RG 132 vs. 49 18% vs. 14% 0% vs. 0%
Procopiuc et al. [36] 2016 Romania OG vs. RG 29 vs. 18 28% vs. 22% 0% vs. 0%
Shen et al. [38] 2016 China LG vs. RG 330 vs. 93 10% vs. 10% -
a
P < 0.05. LDG: laparoscopic distal gastrectomy; LG: laparoscopic gastrectomy; LTG: laparoscopic total gastrectomy; LPPG: laparoscopic
pylorus preservingl gastrectomy; RDG: robotic distal gastrectomy; RG: robotic gastrectomy; RTG: robotic total gastrectomy; RPPG: robotic
pylorus preservingl gastrectomy; ODG: open distal gastrectomy; OG: open gastrectomy

Table 5. Studies which provided long-term survival outcomes
Author Year Country/ Approach Number of Median Follow 5y-OS 5y-DFS
area patients up period (%) (%)
(n) (months)
Son et al. [39] 2014 Korea LTG vs. RTG 58 vs. 51 a 70 a 91.1 vs. 89.5 a 90.2 vs. 91.2
Lee et al. [32] 2015 Korea LDG vs. RDG 267 vs. 133 a 75 a N.S. -
Okumura et al. [34] 2016 Korea OG vs. RG 132 vs. 49 a 58 a N.S. -
Junfeng et al. [27] 2014 America LG vs. RG 394 vs. 120 19 vs. 15 69.9 vs. 67.8 (3y) -
Han et al. [24] 2015 Korea LPPG vs. RPPG 69 vs. 68 19 vs. 23 - -
Nakauchi et al. [17] 2016 Japan LG vs. RG 437 vs. 84 42 vs. 41 88.8 vs. 86.9 (3y) 86.3 vs. 86.9 (3y)
Procopiuc et al. [36] 2016 Romania OG vs. RG 29 vs. 18 32 vs. 25 N.S. -
a median follow up period longer than 3 years. N.S.: statistically not significant difference; LDG: laparoscopic distal gastrectomy; LG:
laparoscopic gastrectomy; LTG: laparoscopic total gastrectomy; LPPG: laparoscopic pylorus preservingl gastrectomy; RDG: robotic
distal gastrectomy; RG: robotic gastrectomy; RTG: robotic total gastrectomy; RPPG: robotic pylorus preservingl gastrectomy; OG: open
gastrectomy

DISCUSSION
RG has several absolute advantages, which include articulated devices, tremor suppression function, and
a fine three-dimensional view, and surgeons can perform operations comfortably with these technologies.
However, these advantages are from the surgeons’ perspective, and it is unclear whether these technologies
applied to RG are also advantageous from the patients’ viewpoint. Theoretically, the more meticulous and
precise surgeries are, the better the outcomes will be. However, for RG to be more widely accepted, advantages
from the patients’ side should be demonstrated in clinical trials, ideally in prospective randomized trials.