Early experience with total robotic D2 gastrectomy in a low incidence region: surgical perspectives

• Published in: BMC surgery 2022-04, Vol.22 (1), p.137-137, Article 137
• Main Authors: Mala, Tom, Førland, Dag, Skagemo, Caroline, Glomsaker, Tom, Johannessen, Hans Olaf, Johnson, Egil
• Format: Article
• Language: English
• Subjects: Adenocarcinoma; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Aged; Aged, 80 and over; Body mass; Body mass index; Body size; Cancer; Complications; Disease susceptibility; Early experience; Esophagus; Feasibility; Female; Gastrectomy; Gastrectomy - methods; Gastric cancer; Gastrointestinal surgery; Hospitals; Humans; Incidence; Laparoscopy; Lymph Node Excision - methods; Lymph nodes; Malignancy; Methylene blue; Minimal invasive; Oncology; Outcome; Patients; Patients rights; Retrospective Studies; Robotic surgery; Robotic Surgical Procedures - methods; Robotics; Robots; Small intestine; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgery; Surgical anastomosis; Sutures; Treatment Outcome; Tumors
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-022-01576-1

Few European centers have reported on robotic gastrectomy for malignancy. We report our early experience with curative-intent total robotic gastrectomy. The Intuitive Surgery Da Vinci Surgical System Xi 4 armed robot was used. Routine D2 lymphadenectomy was applied. Some 27 patients with adenocarcinoma (n = 18), hereditary cancer susceptibility (n = 8) and premalignancy (n = 1) were allocated to robotic gastrectomy, three were excluded due to inoperability during surgery. Median (range) age was 66 (18-87) years, 14 (58.3%) were females and body mass index was 25.5 (22.1-33.5) kg/m . Total gastrectomy was performed in 19 (79.2%) and subtotal in five (20.8%) patients. One (4.2%) procedure was converted to laparotomy. Procedural time was 273 (195-427) minutes. Three (12.5%) patients were reoperated within 30 days, one (4.2%) died. Serious complications (Clavien Dindo IIIb or more) occurred in three (12.5%) patients. Postoperative hospital stay was 10 (6-43) days. Fourteen of 16 (87.5%) patients with adenocarcinoma/premalignancy received radical resections. The median number of harvested lymph nodes was 20 (11-34). Eleven (73.3%) patients with adenocarcinoma had T3/T4 tumors and 6 (40%) had TNM stage III or more. Total robotic D2 gastrectomy appears feasible and safe during early introduction in a low incidence region.