Robotic Gastric Cancer Surgery: What Happened Last Year?

  • Muhammet Kadri ÇolakoğluEmail author
  • Volkan Öter
  • Erdal Birol Bostancı
Robotic Surgery (E. Berber, Section Editor)
Part of the following topical collections:
  1. Robotic Surgery


Purpose of review

This following review aims to evaluate the role of robotic surgery in gastric cancer, comparison with open and laparoscopic alternatives, based on the articles published last year.

Recent Findings

Robotic gastric surgery is a promising and developing platform in the surgical era and its perioperative or oncological results after gastric cancer surgery are still under evaluation. Besides this, the approaches of eastern and western societies in robotic gastric surgery are also different as in open surgery, in some ways.


Robotic gastric surgery seems to be more advantageous to use in early-stage gastric cancers, it causes less bleeding and provides technical advantage to the surgeon. The high cost and the long operation time are still the biggest problems. There is no difference in terms of oncological results compared to other methods. It is feasible and safe alternative to other methods.


Gastric cancer Robotic surgery Minimal invasive surgery 


Compliance with Ethical Guidelines

Conflict of interest

Muhammet Kadri Çolakoğlu, Volkan Öter, and Erdal Birol Bostancı each declare no potential conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    • Antoniou SA, Antoniou GA, Antoniou AI, Granderath FA. Past, present and future of minimally invasive abdominal surgery. JSLS. 2015;19(3):e2015.00052. A study that shows the evolution of abdominal surgery step-by-step.Google Scholar
  2. 2.
    Velanovich V. Laparoscopic vs open surgery: a preliminary comparison of quality of life outcomes. Surg Endosc. 2000;14(1):16–21.CrossRefGoogle Scholar
  3. 3.
    Vinuela EF, Gonen M, Brennan MF, Coit DG, Strong VE. Laparoscopic versus open distal gastrectomy for gastric cancer: a meta-analysis of randomized controlled trials and high-quality nonrandomized studies. Ann Surg. 2012;255:446–56.CrossRefGoogle Scholar
  4. 4.
    Scheidbach H, Schubert D, Köckerling F, Lippert H. Oncologic surgery: the advantages and disadvantages of minimally invasive surgery. Minerva Chir. 2005;60(3):133–8.PubMedGoogle Scholar
  5. 5.
    Hashizume M, Shimada M, Tomikawa M, Ikeda Y, Takahashi I, Abre R, Koga F, Gotoh N, Konishi K, Maehara S, Sugimachi K. Early experiences of endoscopic procedures in general surgery assisted by a computer enhanced surgical system. Surg Endosc. 2002;16:1187–91.CrossRefGoogle Scholar
  6. 6.
    Ruurda JP, van Vroonhoven TJ, Broeders IA. Robot-assisted surgical systems: a new era in laparoscopic surgery. Ann Royal Coll Surg Engl. 2002;84:223–6.CrossRefGoogle Scholar
  7. 7.
    •• Tsai SH, Liu CA, Huang KH, Lan YT, Chen MH, Chao Y, Lo SS, Li AF, Wu CW, Chiou SH, Yang MH, Shyr YM, Fang WL. Advances in Laparoscopic and robotic gastrectomy for gastric cancer. Pathol Oncol Res. 2017;23(1):13–17. It is an original study that compares operative outcomes, learning curves, and oncological outcome of laparoscopic and robotic gastric surgery approaches.Google Scholar
  8. 8.
    •• Li Z, Li B, Bai B, Yu P, Lian B, Zhao Q. Long-term outcomes of laparoscopic versus open D2 gastrectomy for advanced gastric cancer. Surg Oncol. 2018;27(3):441–448. A study, showing that minimally invasive surgery could be equivalent to open surgery for advanced gastric tumors.Google Scholar
  9. 9.
    •• Xu Y, Hua J, Li J, Shi L, Xue H, Shuang J, Du J. Long-term outcomes of laparoscopic versus open gastrectomy for advanced gastric cancer: A large cohort study. Am J Surg. 2018. Another study, showing that minimally invasive surgery could be equivalent to open surgery for advanced gastric tumors.
  10. 10.
    Song J, Oh SJ, Kang WH, Hyung WJ, Choi SH, Noh SH. Robot-assisted gastrectomy with lymph node dissection for gastric cancer: lessons learned from an initial 100 consecutive procedures. Ann Surg. 2009;249(6):927–32.CrossRefGoogle Scholar
  11. 11.
    Berlth F, Yang HK. Minimal invasive gastrectomy: what the west can learn from the east? Updates Surg. 2018;70:181–7.CrossRefGoogle Scholar
  12. 12.
    Strong VE, Song KY, Park CH, Jacks LM, Gonen M, Shah M, Coit DG. Brennan MF Comparison of gastric cancer survival following R0 resection in the United States and Korea using an internationally validated nomogram. Ann Surg. 2010;251(4):640–6.CrossRefGoogle Scholar
  13. 13.
    Yao JC, Schnirer II, Reddy S, Chiang S, Najam A, Yu C, Giacco G, Hess K, Rashid A, Xie K, Lynch P, Ajani JA. Effects of sex and racial/ethnic group on the pattern of gastric cancer localization. Gastric Cancer. 2002;5(4):208–12.CrossRefGoogle Scholar
  14. 14.
    Blot WJ, Devesa SS, Kneller RW, Fraumeni JF Jr. Rising incidence of adenocarcinoma of the esophagus and gastric cardia. JAMA. 1991;265(10):1287–9.CrossRefGoogle Scholar
  15. 15.
    Russo A, Strong VE. Minimally invasive surgery for gastric cancer in USA: current status and future perspectives. Transl Gastroenterol Hepatol. 2017;2:38. Scholar
  16. 16.
    • Greenleaf EK, Sun SX, Hollenbeak CS, Wong J. Minimally invasive surgery for gastric cancer: the American experience. Gastric Cancer. 2017;20:368–378. A good study that reflects perspective of west for gastric surgery.Google Scholar
  17. 17.
    Kostakis ID, Alexandrou A, Armeni E, Damaskos C, Kouraklis G, Diamantis T, Tsigris C. Comparison between minimally invasive and open gastrectomy for gastric cancer in Europe: a systematic review and meta-analysis. Scand J Surg. 2017;106(1):3–20.CrossRefGoogle Scholar
  18. 18.
    Parisi A, Reim D, Borghi F, Nguyen NT, Qi F, Coratti A, Cianchi F, Cesari M, Bazzocchi F, Alimoglu O, Gagniere J, Pernazza G, D’Imporzano S, Zhou YB, Azagra JS, Facy O, Brower ST, Jiang ZW, Zang L, Isik A, Gemini A, Trastulli S, Novotny A, Marano A, Liu T, Annecchiarico M, Badii B, Arcuri G, Avanzolini A, Leblebici M, Pezet D, Cao SG, Goergen M, Zhang S, Palazzini G, D’Andrea V, Desiderio J. Minimally invasiive surgery for gastric cancer: a comparison between robotic, laparoscopic and open surgery. World J Gastroenterol. 2017;23(13):2376–84.CrossRefGoogle Scholar
  19. 19.
    Caruso R, Vicente E, Quijano Y, Lelpo B, Duran H, Diaz E, Fabra I, Ferri V. Robotic assisted gastrectomy compared with open resection: a case matched study. Updates Surg. 2018. Scholar
  20. 20.
    Yang Y, Wang G, He J, Wu F, Ren S. Robotic gastrectomy versus open gastrectomy in the treatment of gastric cancer. J Cancer Res Clin Oncol. 2017;143:105–14.CrossRefGoogle Scholar
  21. 21.
    Yang SY, Roh KH, Kim YN, Cho M, Lim SH, Son T, Hyung WY, Kim HI. Surgical outcomes after open, laparocopic and robotic gastrectomy for gastric cancer. Ann Surg Oncol. 2017;24(7):1770–7.CrossRefGoogle Scholar
  22. 22.
    Gavriilidis P, Lim C, Menahem B, Lahat E, Salloum C, Azoulay D. Robotic versus laparoscopic distal pancreatectomy—the first meta-analysis. HPB. 2016;18(7):567–74.CrossRefGoogle Scholar
  23. 23.
    Gorgun E, Ozben V, Costedio M, Stocchi L, KAlady M, Remzi F. Robotic versus conventional laparoscopic rectal cancer surgery in obese patients. Colorectal Dis. 2016;18(11):1063–71.CrossRefGoogle Scholar
  24. 24.
    Waite KE, Herman MA, Doyle PJ. Comparison of robotic versus laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. J Robot Surg. 2016;10(3):239–44.CrossRefGoogle Scholar
  25. 25.
    Wang Y, Zhao X, Song Y, Cai A, Xi H, Chen L. A systematic review and meta-analysis of robot-assisted versus laparoscopically assisted gastrectomy for gastric cancer. Medicine. 2017;96(48):e8797.CrossRefGoogle Scholar
  26. 26.
    Lu J, Zheng HL, Li P, Xie JW, Wang JB, Lin JX, Chen QY, Cao LL, Lin M, Tu RH, Huang ZN, Huang CM, Zheng CH. A propensity score-matched comparison of robotic versus laparoscopic gastrectomy for gastric cancer: oncological, cost and surgical stress analysis. J Gastrointest Surg. 2018. Scholar
  27. 27.
    Hikage M, Tokunaga M, Makuuchi R, Irino T, Tanizawa Y, Bando E, Kawamura T, Terashima M. Comparison of surgical outcomes between robotic and laparoscopic distal gastrectomy for cT1 gastric cancer. World J Surg. 2018;42(6):1803–10.CrossRefGoogle Scholar
  28. 28.
    Guerra F, Giuliani G, Formisano G, Bianchi PP, Patriti A, Coratti A. Pancreatic complications after conventional laparoscopic radical gastrectomy versus robotic radical gastrectomy: systematic review and meta-analysis. J Laparoendosc Adv Surg Tech A. 2018;28(10):1207–15.CrossRefGoogle Scholar
  29. 29.
    Chen K, Pan Y, Zhang B, Maher H, Wang XF, Cai XJ. Robotic versus laparoscopic gastrectomy for gastric cancer: a systematic review and updated meta-analysis. BMC Surg. 2017;17(1):93.CrossRefGoogle Scholar
  30. 30.
    Gao Y, Xi H, Qiao Z, Li J, Zhang K, Xie T, Shen W, Cui J, Wei B, Chen L. Comparison of robotic and laparoscopic assisted gastrectomy in advanced gastric cancer: updated short and long term results. Surg Endos. 2018. Scholar
  31. 31.
    Obama K, Kim YM, Kang DR, Son T, Kim HI, Noh SH, Hyung WJ. Long term oncologic outcomes of robotic gastrectomy for gastric cancer compared with laparoscopic gastrectomy. Gastric Cancer. 2018;21(2):285–95.CrossRefGoogle Scholar
  32. 32.
    Pan JH, Zhou H, Zhao XX, Ding H, Qin L, Pan YL. Long term oncological outcomes in robotic gastrectomy versus laparoscopic gastrectomy for gastric cancer: a meta analysis. Surg Endosc. 2017;31(10):4244–51.CrossRefGoogle Scholar
  33. 33.
    Duan BS, Zhao J, Xie LF, Wang Y. Robotic verse laparoscopic gastrectomy for gastric cancer: a pooled analysis of 11 individual studies. Surg Laparosc Endosc Percutan Tech. 2017;27(3):147–53.CrossRefGoogle Scholar
  34. 34.
    Pan HF, Wang G, Liu J, Liu XX, Zhao K, Tang XF. Jiang ZW Robotic versus laparoscopic gastrectomy for locally advanced gastric cancer. Surg Laparosc Endosc Percutan Tech. 2017;27(6):428–33.CrossRefGoogle Scholar
  35. 35.
    Huang KH, Lan YT, Fang WL, Chen JH, Lo SS, Li AF, Chiou SH, Wu CW, Shyr YM. Comparison of the operative outcomes and learning curves between laparoscopic and robotic gastrectomy for gastric cancer. PLoS ONE. 2014;9(10):e111499.CrossRefGoogle Scholar
  36. 36.
    Kim HI, Park MS, Song KJ, Woo Y. Hyung WJ (2014) Rapid and safe learning of robotic gastrectomy for gastric cancer: multidimensional analysis in a comparison with laparoscopic gastrectomy. Eur J Surg Oncol. 2014;40(10):1346–54.CrossRefGoogle Scholar
  37. 37.
    Song J, Kang WH, Oh SJ, Hyung WJ, Choi SH, Noh SH. Role of robotic gastrectomy using da Vinci system compared with laparoscopic gastrectomy: initial experience of 20 consecutive cases. Surg Endosc. 2009;23(6):1204–11.CrossRefGoogle Scholar
  38. 38.
    Heemskerk J, van Gemert WG, de Vries J, Greve J, Bouvy ND. Learning curve of robot-assisted laparoscopic surgery compared with conventional laparoscopic surgery: an experimental study evaluating skill acquisition of robot-assisted laparoscopic tasks compared with conventional laparoscopic tasks in inexperienced users. Surg Laparosc Endosc Percutan Tech. 2007;17(3):171–4.CrossRefGoogle Scholar
  39. 39.
    Park SS, Kim MC, Park MS, Hyung WJ. Rapid adaptation of robotic gastrectomy for gastric cancer by experienced laparoscopic surgeons. Surg Endosc. 2012;26(1):60–7.CrossRefGoogle Scholar
  40. 40.
    Hong SS, Son SY, Shin HJ, Cui LH, Hur H, Han SU. Can robotic gastrectomy surpass laparoscopic gastrectomy by acquiring long-term experience? A propensity score analysis of a 7-year experience at a single institution. J Gastric Cancer. 2016;16(4):240–6.CrossRefGoogle Scholar
  41. 41.
    An JY, Kim SM, Ahn S, Choi MG, Lee JH, Sohn TS, Bae JM, Kim S. Successful robotic gastrectomy does not require extensive laparoscopic experience. J Gastric Cancer. 2018;18(1):90–8.CrossRefGoogle Scholar
  42. 42.
    Kang BH, Xuan Y, Hur H, Ahn CW, Cho YK, Han SU. Comparison of surgical outcomes between robotic and laparoscopic gastrectomy for gastric cancer: the learning curve of robotic surgery. J Gastric Cancer. 2012;12(3):156–63.CrossRefGoogle Scholar
  43. 43.
    Liu HB, Wang WJ, Li HT, Han XP, Su L, Wei DW, Cao TB, Yu JP, Jiao ZY. Robotic versus conventional laparoscopic gastrectomy for gastric cancer: a retrospective cohort study. Int J Surg. 2018;55:15–23.CrossRefGoogle Scholar
  44. 44.
    Eom BW, Yoon HM, Ryu KW, Lee JH, Cho SJ, Lee JY, Kim CG, Choi IJ, Lee JS, Kook MC, Rhee JY, Park SR, Kim YW. Comparison of surgical performance and short-term clinical outcomes between laparoscopic and robotic surgery in distal gastric cancer. Eur J Surg Oncol. 2012;38:57–63.CrossRefGoogle Scholar
  45. 45.
    Park JY, Jo MJ, Nam BH, et al. Surgical stress after robot-assisted distal gastrectomy and its economic implications. Br J Surg. 2012;99:1554–61.CrossRefGoogle Scholar
  46. 46.
    Barbash GI, Glied SA. New technology and health care costs: the case of robot-assisted surgery. N Engl J Med. 2010;363:701–4.CrossRefGoogle Scholar
  47. 47.
    Liu CA, Huang KH, Chen MH, Lo SS, Li AF, Wu CW, Shyr YM, Fang WL. Comparison of the surgical outcomes of minimally invasive and open surgery for octogenarian and older compared to younger gastric cancer patients: a retrospective cohort study. BMC Surg. 2017;17(1):68. Scholar
  48. 48.
    Seo WJ, Son T, Roh CK, Cho M, Kim HI, Hyung WJ. Reduced port totally robotic distal gastrectomy with lymph node dissection for gastric cancer: a modified technique using Single-Site and two additional ports. Surg Endosc. 2018;32(8):3713–9.CrossRefGoogle Scholar
  49. 49.
    Lee S, Kim JK, Kim YN, Jang DS, Kim YM, Son T, Hyung WJ, Kim HI. Safety and feasibility of reduced-port robotic distal gastrectomy for gastric cancer: a phase I/II clinical trial. Surg Endosc. 2017;31(10):4002–9.CrossRefGoogle Scholar
  50. 50.
    Kim M, Son SY, Cui LH, Shin HJ, Hur H, Han SU. Real-time vessel navigation using indocyanine green fluorescence during robotic or laparoscopic gastrectomy for gastric cancer. J Gastric Cancer. 2017;17(2):145–53.CrossRefGoogle Scholar
  51. 51.
    Lan YT, Huang KH, Chen PH, Liu CA, Lo SS, Wu CW, Shyr YM, Fang WL. A pilot study of lymph node mapping with indocyanine green in robotic gastrectomy for gastric cancer. SAGE Open Med. 2017. Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Muhammet Kadri Çolakoğlu
    • 1
    Email author
  • Volkan Öter
    • 2
  • Erdal Birol Bostancı
    • 3
  1. 1.Department of General SurgeryRecepTayyip Erdogan University Faculty of MedicineRizeTurkey
  2. 2.Department of Gastroenterology SurgerySakarya University Faculty of MedicineSakaryaTurkey
  3. 3.Department of Gastroenterology SurgeryYuksek İhtisas Training and Research HospitalAnkaraTurkey

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