Technical feasibility of robot-sewn anastomosis in robotic surgery for gastric cancer

Although several studies have reported on the feasibility of robot-assisted gastric cancer surgery using the da Vinci surgical system, reconstruction techniques have depended on staplers or hand sewing through minilaparotomy. The aim of this study is to report on the feasibility of reconstruction methods using a robot-sewing technique in robotic surgery for treatment of gastric cancer. Between January and April 2010, 7 patients in whom gastric adenocarcinoma was diagnosed underwent robotic surgery including robot-sewn anastomosis. We demonstrated the surgical techniques with analysis of clinicopathologic characteristics and surgical outcomes. All robotic surgeries were performed without other laparoscopic instruments. Two Roux-en-Y reconstructions for two total gastrectomy, two Roux-en-Y reconstructions, and three gastroduodenostomies, for five subtotal gastrectomies, were successfully accomplished. Total median operation time was 205 minutes, and median reconstruction time was 69 minutes. One patient was readmitted for stasis in the remnant stomach but conservatively recovered. A robot-sewn anastomosis for reconstruction in robotic surgery for gastric cancer was feasible regardless of the reconstruction method.