Should robotic gastrectomy become a standard surgical treatment option for gastric cancer?

  • Susumu Shibasaki
  • Koichi SudaEmail author
  • Kazutaka Obama
  • Masahiro Yoshida
  • Ichiro Uyama
Review Article


Robotic gastrectomy (RG) using the da Vinci Surgical System for gastric cancer was approved for national medical insurance coverage in Japan in April, 2018, and has been used increasingly since. We reviewed the current evidence on RG, open gastrectomy (OG), and conventional laparoscopic gastrectomy (LG) to identify differences in surgical outcomes between Japan and other countries. Briefly, three independent reviewers systematically reviewed the data collected from a comprehensive literature search by an independent organization and focused on the following nine endpoints: mortality, morbidity, operative time, estimated volume of blood loss, length of postoperative hospital stay, long-term oncologic outcome, quality of life, learning curve, and cost. Overall, the mortality rate of the three approaches did not differ, but RG and LG had less intraoperative blood loss and resulted in a shorter postoperative hospital stay than OG. RG had longer operative times and incurred higher costs than LG and OG. However, in Japan, RG may be more effective than LG and OG for decreasing morbidity. Further studies are needed to establish the specific indications for RG, optimal robotic setup, and dissection methods to best utilize the surgical robot.


Stomach neoplasms Minimally invasive surgical procedures Robotics Gastrectomy 



This work was not supported by any specific grants or funding.

Compliance with ethical standards

Conflict of interest

K.S. has a financial relationship with Medicaroid, Inc. (Advisory fee, 900 USD/M) outside the submitted work. S.S., K.O., M.Y., and I.U. have no conflicts of interest.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of SurgeryFujita Health UniversityToyoakeJapan
  2. 2.Department of SurgeryKyoto University Graduate School of MedicineKyotoJapan
  3. 3.Department of Hepato-Biliary-Pancreatic and Gastrointestinal SurgeryInternational University of Health and WelfareIchikawaJapan

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