Full robot-assisted gastrectomy: surgical technique and preliminary experience from a single center
The treatment of gastric cancer requires a multidisciplinary approach in which surgery plays the main role. The diffusion of minimally invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended lymphadenectomy. This surgical step can be facilitated through t...
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| Veröffentlicht in: | Journal of robotic surgery 2016-12, Vol.10 (4), p.297-306 |
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| creator | Quijano, Yolanda Vicente, Emilio Ielpo, Benedetto Duran, Hipolito Diaz, Eduardo Fabra, Isabel Malave, Luis Ferri, Valentina Ferronetti, Antonio Plaza, Carlos D’Andrea, Vito Caruso, Riccardo |
| description | The treatment of gastric cancer requires a multidisciplinary approach in which surgery plays the main role. The diffusion of minimally invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended lymphadenectomy. This surgical step can be facilitated through the use of a robot-assisted system. To date, there are few published articles discussing a full robotic approach that precisely show the different surgical steps. The aim of this study is to describe our experience, surgical techniques and the short-term results of a consecutive series of full robotic gastrectomies using the Da Vinci Surgical System. From November 2011 to January 2015, 17 patients with gastric cancer underwent curative resection by robotic approach for locally advanced tumors. In summary, there were 15 total gastrectomies with a Roux-en-Y esophagojejunostomy, one total gastrectomy with transverse colectomy and one sub-total gastrectomy. Resection margins were negative in all cases. Conversions occurred in two patients. Robot-assisted gastrectomy with extended lymphadenectomy is a safe technique and successfully allows an adequate lymph node harvest and optimal R0-resection rates with low postoperative morbidity. The learning curve appears to be shorter than in laparoscopic surgery. Further follow-up and randomized clinical trials are required to confirm the role of a robotic approach in gastric cancer surgery. |
| doi_str_mv | 10.1007/s11701-016-0591-y |
| format | Article |
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The diffusion of minimally invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended lymphadenectomy. This surgical step can be facilitated through the use of a robot-assisted system. To date, there are few published articles discussing a full robotic approach that precisely show the different surgical steps. The aim of this study is to describe our experience, surgical techniques and the short-term results of a consecutive series of full robotic gastrectomies using the Da Vinci Surgical System. From November 2011 to January 2015, 17 patients with gastric cancer underwent curative resection by robotic approach for locally advanced tumors. In summary, there were 15 total gastrectomies with a Roux-en-Y esophagojejunostomy, one total gastrectomy with transverse colectomy and one sub-total gastrectomy. Resection margins were negative in all cases. Conversions occurred in two patients. Robot-assisted gastrectomy with extended lymphadenectomy is a safe technique and successfully allows an adequate lymph node harvest and optimal R0-resection rates with low postoperative morbidity. The learning curve appears to be shorter than in laparoscopic surgery. Further follow-up and randomized clinical trials are required to confirm the role of a robotic approach in gastric cancer surgery.</description><identifier>ISSN: 1863-2483</identifier><identifier>EISSN: 1863-2491</identifier><identifier>DOI: 10.1007/s11701-016-0591-y</identifier><identifier>PMID: 27178540</identifier><language>eng</language><publisher>London: Springer London</publisher><subject><![CDATA[Abdomen ; Adenocarcinoma - drug therapy ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Roux-en-Y ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Blood Loss, Surgical - statistics & numerical data ; Blood Transfusion - statistics & numerical data ; Cancer ; Cancer therapies ; Capecitabine - administration & dosage ; Chemotherapy ; Combined Modality Therapy ; Disease ; Dissection ; Drug Administration Schedule ; Epirubicin - administration & dosage ; Female ; Gastrectomy - methods ; Gastric cancer ; Gastrointestinal surgery ; Hospitals ; Humans ; Infusions, Intravenous ; Laparoscopy ; Learning Curve ; Learning curves ; Lymphatic system ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Minimally Invasive Surgery ; Operative Time ; Organoplatinum Compounds - administration & dosage ; Original Article ; Patients ; Perioperative Care - methods ; Prospective Studies ; Robotic surgery ; Robotic Surgical Procedures - methods ; Robots ; Stomach Neoplasms - drug therapy ; Stomach Neoplasms - surgery ; Surgeons ; Surgery ; Surgical techniques ; Urology ; Young Adult]]></subject><ispartof>Journal of robotic surgery, 2016-12, Vol.10 (4), p.297-306</ispartof><rights>Springer-Verlag London 2016</rights><rights>Springer-Verlag London 2016.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-4fe5ebe9facdd5e2da8f5233cabecb630c3c16f0e0b9e146c9d15eb6c59024763</citedby><cites>FETCH-LOGICAL-c438t-4fe5ebe9facdd5e2da8f5233cabecb630c3c16f0e0b9e146c9d15eb6c59024763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11701-016-0591-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2918715479?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21367,27901,27902,33721,33722,41464,42533,43781,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27178540$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Quijano, Yolanda</creatorcontrib><creatorcontrib>Vicente, Emilio</creatorcontrib><creatorcontrib>Ielpo, Benedetto</creatorcontrib><creatorcontrib>Duran, Hipolito</creatorcontrib><creatorcontrib>Diaz, Eduardo</creatorcontrib><creatorcontrib>Fabra, Isabel</creatorcontrib><creatorcontrib>Malave, Luis</creatorcontrib><creatorcontrib>Ferri, Valentina</creatorcontrib><creatorcontrib>Ferronetti, Antonio</creatorcontrib><creatorcontrib>Plaza, Carlos</creatorcontrib><creatorcontrib>D’Andrea, Vito</creatorcontrib><creatorcontrib>Caruso, Riccardo</creatorcontrib><title>Full robot-assisted gastrectomy: surgical technique and preliminary experience from a single center</title><title>Journal of robotic surgery</title><addtitle>J Robotic Surg</addtitle><addtitle>J Robot Surg</addtitle><description>The treatment of gastric cancer requires a multidisciplinary approach in which surgery plays the main role. The diffusion of minimally invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended lymphadenectomy. This surgical step can be facilitated through the use of a robot-assisted system. To date, there are few published articles discussing a full robotic approach that precisely show the different surgical steps. The aim of this study is to describe our experience, surgical techniques and the short-term results of a consecutive series of full robotic gastrectomies using the Da Vinci Surgical System. From November 2011 to January 2015, 17 patients with gastric cancer underwent curative resection by robotic approach for locally advanced tumors. In summary, there were 15 total gastrectomies with a Roux-en-Y esophagojejunostomy, one total gastrectomy with transverse colectomy and one sub-total gastrectomy. Resection margins were negative in all cases. Conversions occurred in two patients. Robot-assisted gastrectomy with extended lymphadenectomy is a safe technique and successfully allows an adequate lymph node harvest and optimal R0-resection rates with low postoperative morbidity. The learning curve appears to be shorter than in laparoscopic surgery. Further follow-up and randomized clinical trials are required to confirm the role of a robotic approach in gastric cancer surgery.</description><subject>Abdomen</subject><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anastomosis, Roux-en-Y</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Blood Loss, Surgical - statistics & numerical data</subject><subject>Blood Transfusion - statistics & numerical data</subject><subject>Cancer</subject><subject>Cancer therapies</subject><subject>Capecitabine - administration & dosage</subject><subject>Chemotherapy</subject><subject>Combined Modality Therapy</subject><subject>Disease</subject><subject>Dissection</subject><subject>Drug Administration Schedule</subject><subject>Epirubicin - administration & dosage</subject><subject>Female</subject><subject>Gastrectomy - methods</subject><subject>Gastric cancer</subject><subject>Gastrointestinal surgery</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infusions, Intravenous</subject><subject>Laparoscopy</subject><subject>Learning Curve</subject><subject>Learning curves</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgery</subject><subject>Operative Time</subject><subject>Organoplatinum Compounds - administration & dosage</subject><subject>Original Article</subject><subject>Patients</subject><subject>Perioperative Care - methods</subject><subject>Prospective Studies</subject><subject>Robotic surgery</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Robots</subject><subject>Stomach Neoplasms - drug therapy</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgical techniques</subject><subject>Urology</subject><subject>Young Adult</subject><issn>1863-2483</issn><issn>1863-2491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kUlLxTAUhYMozj_AjQTcuKnmNs1QdyJOILjRdUjT22ekTZ9JC75_b-Q5gODqBu53Tk5yCDkCdgaMqfMEoBgUDGTBRA3FaoPsgpa8KKsaNn_Omu-QvZReGRNKcNgmO6UCpUXFdom7mfuexrEZp8Km5NOELV3YNEV00zisLmia48I729MJ3UvwbzNSG1q6jNj7wQcbVxTflxg9Boe0i-NALU0-LHqkDsOE8YBsdbZPePg198nzzfXT1V3x8Hh7f3X5ULiK66moOhTYYN1Z17YCy9bqTpScO9ugayRnjjuQHUPW1AiVdHULWSCdqFlZKcn3yenadxnHHDNNZvDJYd_bgOOcDOhSSi24Vhk9-YO-jnMMOZ0pa9AKRKXqTMGacnFMKWJnltEP-cUGmPlswKwbMLkB89mAWWXN8Zfz3AzY_ii-vzwD5RpIeRUWGH-v_t_1A1s_k54</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Quijano, Yolanda</creator><creator>Vicente, Emilio</creator><creator>Ielpo, Benedetto</creator><creator>Duran, Hipolito</creator><creator>Diaz, Eduardo</creator><creator>Fabra, Isabel</creator><creator>Malave, Luis</creator><creator>Ferri, Valentina</creator><creator>Ferronetti, Antonio</creator><creator>Plaza, Carlos</creator><creator>D’Andrea, Vito</creator><creator>Caruso, Riccardo</creator><general>Springer London</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>L6V</scope><scope>M0S</scope><scope>M7S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>7X8</scope></search><sort><creationdate>20161201</creationdate><title>Full robot-assisted gastrectomy: surgical technique and preliminary experience from a single center</title><author>Quijano, Yolanda ; Vicente, Emilio ; Ielpo, Benedetto ; Duran, Hipolito ; Diaz, Eduardo ; Fabra, Isabel ; Malave, Luis ; Ferri, Valentina ; Ferronetti, Antonio ; Plaza, Carlos ; D’Andrea, Vito ; Caruso, Riccardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-4fe5ebe9facdd5e2da8f5233cabecb630c3c16f0e0b9e146c9d15eb6c59024763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abdomen</topic><topic>Adenocarcinoma - 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Academic</collection><jtitle>Journal of robotic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Quijano, Yolanda</au><au>Vicente, Emilio</au><au>Ielpo, Benedetto</au><au>Duran, Hipolito</au><au>Diaz, Eduardo</au><au>Fabra, Isabel</au><au>Malave, Luis</au><au>Ferri, Valentina</au><au>Ferronetti, Antonio</au><au>Plaza, Carlos</au><au>D’Andrea, Vito</au><au>Caruso, Riccardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Full robot-assisted gastrectomy: surgical technique and preliminary experience from a single center</atitle><jtitle>Journal of robotic surgery</jtitle><stitle>J Robotic Surg</stitle><addtitle>J Robot Surg</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>10</volume><issue>4</issue><spage>297</spage><epage>306</epage><pages>297-306</pages><issn>1863-2483</issn><eissn>1863-2491</eissn><abstract>The treatment of gastric cancer requires a multidisciplinary approach in which surgery plays the main role. The diffusion of minimally invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended lymphadenectomy. This surgical step can be facilitated through the use of a robot-assisted system. To date, there are few published articles discussing a full robotic approach that precisely show the different surgical steps. The aim of this study is to describe our experience, surgical techniques and the short-term results of a consecutive series of full robotic gastrectomies using the Da Vinci Surgical System. From November 2011 to January 2015, 17 patients with gastric cancer underwent curative resection by robotic approach for locally advanced tumors. In summary, there were 15 total gastrectomies with a Roux-en-Y esophagojejunostomy, one total gastrectomy with transverse colectomy and one sub-total gastrectomy. Resection margins were negative in all cases. Conversions occurred in two patients. Robot-assisted gastrectomy with extended lymphadenectomy is a safe technique and successfully allows an adequate lymph node harvest and optimal R0-resection rates with low postoperative morbidity. The learning curve appears to be shorter than in laparoscopic surgery. Further follow-up and randomized clinical trials are required to confirm the role of a robotic approach in gastric cancer surgery.</abstract><cop>London</cop><pub>Springer London</pub><pmid>27178540</pmid><doi>10.1007/s11701-016-0591-y</doi><tpages>10</tpages></addata></record> |
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| subjects | Abdomen Adenocarcinoma - drug therapy Adenocarcinoma - surgery Adult Aged Aged, 80 and over Anastomosis, Roux-en-Y Antineoplastic Combined Chemotherapy Protocols - therapeutic use Blood Loss, Surgical - statistics & numerical data Blood Transfusion - statistics & numerical data Cancer Cancer therapies Capecitabine - administration & dosage Chemotherapy Combined Modality Therapy Disease Dissection Drug Administration Schedule Epirubicin - administration & dosage Female Gastrectomy - methods Gastric cancer Gastrointestinal surgery Hospitals Humans Infusions, Intravenous Laparoscopy Learning Curve Learning curves Lymphatic system Male Medicine Medicine & Public Health Middle Aged Minimally Invasive Surgery Operative Time Organoplatinum Compounds - administration & dosage Original Article Patients Perioperative Care - methods Prospective Studies Robotic surgery Robotic Surgical Procedures - methods Robots Stomach Neoplasms - drug therapy Stomach Neoplasms - surgery Surgeons Surgery Surgical techniques Urology Young Adult |
| title | Full robot-assisted gastrectomy: surgical technique and preliminary experience from a single center |
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