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Makuuchi et al. Mini-invasive Surg 2019;3:11 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.03

Review Open Access

Robotic surgery for gastric cancer

Rie Makuuchi, Satoshi Kamiya, Yutaka Tanizawa, Etsuro Bando, Masanori Terashima

Division of Gastric Surgery, Shizuoka Cancer Center, Nagaizumi-cho, Sunto-gun, Shizuoka 411-5222, Japan.

Correspondence to: Prof. Masanori Terashima, Division of Gastric Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo,
Nagaizumi-cho, Sunto-gun, Shizuoka 411-5222, Japan. E-mail: m.terashima@scchr.jp

How to cite this article: Makuuchi R, Kamiya S, Tanizawa Y, Bando E, Terashima M. Robotic surgery for gastric cancer. Mini-
invasive Surg 2019;3:11. http://dx.doi.org/10.20517/2574-1225.2019.03
Received: 17 Jan 2018 First Decision: 26 Feb 2019 Revised: 18 Mar 2019 Accepted: 18 Mar 2019 Published: 19 Apr 2019

Science Editor: Tetsu Fukunaga Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Abstract
The number of robotic gastrectomy (RG) cases is increasing, especially in East Asia. The da Vinci Surgical System for
RG allows surgeons to perform meticulous procedures using articulated devices and provides potential advantages over
laparoscopic gastrectomy (LG). Meta-analyses including a large number of retrospective studies comparing RG and
LG revealed only a limited advantage for RG over LG, such as lower blood loss, and the obvious disadvantage of longer
operation times and higher medical cost. Specifically, a multicenter, prospective, single-arm study performed in Japan
showed favorable short-term outcomes of RG over LG, while a non-randomized controlled trial in Korea showed similar
postoperative complication rates for RG and LG, although the medical costs were significantly higher in RG. A well-
designed randomized controlled trial is thus necessary to establish robust evidence comparing the two surgeries. In
addition, further development of surgical robotics is expected for RG to be accepted more widely.

Keywords: Gastric cancer, robotic gastrectomy, surgery, minimum invasive surgery

INTRODUCTION
Gastric cancer is the third leading cause of cancer-related deaths and the fifth most common cancer
[1]
worldwide . Gastrectomy with radical lymphadenectomy is a mainstay of treatment on resectable gastric
cancer; however, recent randomized controlled trials have demonstrated inferiorities of such expanded
[2-5]
and invasive procedures . In contrast, minimally invasive surgery including laparoscopic gastrectomy
[6]
(LG) and robotic gastrectomy (RG) is attracting attention. LG was first introduced in 1991 in Japan , and
since then, this procedure is used all over the world. The reported advantages of LG over radical open
gastrectomy are faster recovery from the surgical stress, less bleeding, good cosmetic results, and shorter

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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