CASE REPORT
Robotic radical gastrectomy - own experience and review of literature
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Wojskowy Instytut Medyczny - Państwowy Instytut Badawczy, Klinika Chirurgii Ogólnej, Onkologicznej, Metabolicznej i Torakochirurgii, Polska
Submission date: 2022-11-30
Acceptance date: 2023-01-26
Publication date: 2023-09-30
Corresponding author
Rafał Roszkowski
Wojskowy Instytut Medyczny - Państwowy Instytut Badawczy, Klinika Chirurgii Ogólnej, Onkologicznej, Metabolicznej i Torakochirurgii, Warszawa
LW 2023;101(3):239-245
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ABSTRACT
Introduction: Gastric cancer is the fifth most common cancer worldwide. Surgery or endoscopic treatment is essential in all disease stages. The most common procedure is total gastrectomy with D2 lymphadenectomy. Removal of stomach and lymph nodes can be performed using minimally invasive techniques. These include laparoscopic gastrectomy, present in gastric cancer surgery since 1994 and robotic gastrectomy, which appeared for the first time in 2003. Last-mentioned
method is the youngest and the most technically advanced form of surgical treatment of gastric cancer. First laparoscopic robot-assisted total gastrectomy in Poland was reported by Marek Zawadzki. In this paper we present technique of totally robotic total gastrectomy. Aim: Presentation of our experience in robotic radical gastrectomy. Description of first in Poland totally robotic gastrectomy. Review of literature assessing novel minimally invasive technique in gastric cancer treatment - robotic gastrectomy. Material and methods: Presentation of our own experience in robotic surgery. Review of literature. Results: Robotic gastrectomy as an alternative to the laparoscopic technique is associated with earlier return of bowel motility after surgery and earlier introduction of a liquid diet. In terms of perioperative and postoperative complications, morbidity, and mortality, as well as a need to convert to open surgery, the laparoscopic and robotic techniques do not differ from each other. In our Department for the first time in Poland totally robotic radical gastrectomy using da Vinci Xi ® Surgical System (Intuitive Surgical) was performed. No postoperative complications were observed. Conclusions: Totally robotic radical gastrectomy is a safe alternative to classic and laparoscopic surgery which can have additional benefits both for the surgeon (less exhaustion, ergonomy, lack of hand tremor on instruments) as for the patient (earlier tolerance of oral diet, earlier hospital discharge). Further study is needed to assess relevance of potential benefits and cost-effectiveness of this novel technique.