What Is Minimally Invasive Surgery for Patients with Gastric Cancer?

Objective: Minimally invasive gastrectomy is performed worldwide because it confers less stress and pain for patients with gastric cancer. Recently, other types of minimally invasive gastrectomy, which include robotic gastrectomy, have also been developed. In this paper, we will review the history, current status, and future prospects of minimally invasive gastrectomy. Methods: We overviewed gastric cancer and reviewed the outcomes of previous clinical trials. In addition, we present our newly developed technique of minimally invasive gastrectomy, especially for anastomosis. Results: Previous clinical trials showed that minimally invasive gastrectomy was similar or superior to open gastrectomy in terms of short-term results, while minimally invasive gastrectomy was not superior to open gastrectomy in terms of long-term survival. Many studies have reported that postoperative complications could induce cancer recurrence; hence, we hypothesize that the survival of patients who underwent minimally invasive gastrectomy will be better than that of patients who underwent open gastrectomy. An intracorporeal anastomosis might help decrease the incidence of postoperative complication because it can shorten the length of surgical incisions. However, this procedure requires experienced skilled surgeons. Conclusion: The surgical system of minimally invasive gastrectomy, including robotic gastrectomy, has dramatically improved. Although there are challenges that need to be addressed, we believe that using more advanced technology or equipment will make minimally invasive gastrectomy the standard treatment for gastric cancer in the future.