Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: Initial experience of 20 consecutive cases

Background: Robotic surgery was invented to overcome the demerits of laparoscopic surgery. However, the role of robotic surgery in gastrectomy has rarely been reported. This study aimed to evaluate the use of robot-assisted distal subtotal gastrectomy to facilitate surgical training for gastric cancer. Methods: Twenty gastric cancer patients who underwent robotic gastrectomy from July 2005 to November 2006 were compared with 20 initial patients who underwent laparoscopic subtotal gastrectomy from May 2003 to August 2003 and 20 recent patients who underwent laparoscopic subtotal gastrectomy during the same period as the 20 robotic gastrectomy procedures by the same surgeon. Result: All 60 patients underwent subtotal gastrectomies with gastroduodenostomy without open or laparoscopic conversion. Operation time for robotic gastrectomy, initial laparoscopic gastrectomy, and recent laparoscopic gastrectomy was 230 min (range 171-312 min), 289.5 min (range 190-450 min), and 134.1 min (range 90-260 min). The number of retrieved lymph nodes was 35.3 ± 10.5, 31.5 ± 17.1, and 42.7 ± 14.9, respectively. Hospital stay was 5.7, 7.7, and 6.2 days, respectively. Postoperative complication occurred in two patients in recent laparoscopic gastrectomy and one patient each in robotic and initial laparoscopic gastrectomy. Conclusion: In this context, it could be assumed that experienced laparoscopic surgeons could perform robotic gastrectomy with a certain level of skill, even in initial series.