Skip to main content

Laparoscopic and Robot Assisted Gastrectomy

  • Chapter
  • First Online:
Minimally Invasive Surgery for Upper Abdominal Cancer

Abstract

The advantages of minimally invasive approaches would be less postoperative pain, better cosmesis, less inflammatory reaction, rapid recovery of bowel function, well-preserved immune function, short hospital stay, and a rapid return to normal social activity. After the initial introduction of laparoscopic gastrectomy for gastric cancer by Kitano and colleagues in 1993 [1], it has rapidly spread out, and now it is considered as one of the standard minimally invasive procedures for the treatment of gastric cancer especially for early stage. For example, in Korea, the number of laparoscopic surgery for gastric cancer increased from 740 in 2004 to 3783 in 2009 respectively, which accounts for 6.6 and 25.8% of all gastric cancer surgeries in each year [2]. Now most of early gastric cancer is done by laparoscopic procedure. Over the last two decades, important clinical evidences for laparoscopic gastrectomy came mainly from Korea to Japan.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kitano S, Iso Y, Moriyama M, Sugimachi K. Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc. 1994;4:146–8.

    CAS  PubMed  Google Scholar 

  2. Lee HJ, Yang HK. Laparoscopic gastrectomy for gastric cancer. Dig Surg. 2013;30(2):132–41.

    Article  PubMed  Google Scholar 

  3. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.

    Article  Google Scholar 

  4. Lee HJ, Shiraishi N, Kim HH, Hiki N, Uyama I, Choi SH, Yang HK, Kitano S. Standard of practice on laparoscopic gastric cancer surgery in Korea and Japan: experts’ survey. Asian J Endosc Surg. 2012;5:5–11.

    Article  CAS  PubMed  Google Scholar 

  5. Kanaya S, Kawamura Y, Kawada H, Iwasaki H, Gomi T, Satoh S, Uyama I. The delta-shaped anastomosis in laparoscopic distal gastrectomy: analysis of the initial 100 consecutive procedures of intracorporeal gastroduodenostomy. Gastric Cancer. 2011;14:365–71.

    Article  PubMed  Google Scholar 

  6. Han TS, Kong SH, Lee HJ, Ahn HS, Hur K, Yu J, Kim WH, Yang HK. Dissemination of free cancer cells from the gastric lumen and from perigastric lymphovascular pedicles during radical gastric cancer surgery. Ann Surg Oncol. 2011;18(10):2818–25. doi:10.1245/s10434-011-1620-8.

    Article  PubMed  Google Scholar 

  7. Kim W, Kim HH, Han SU, Kim MC, Hyung WJ, Ryu SW, Cho GS, Kim CY, Yang HK, Park DJ, Song KY, Lee SI, Ryu SY, Lee JH, Lee HJ. Korean Laparo-endoscopic Gastrointestinal Surgery Study (KLASS) Group: decreased morbidity of laparoscopic distal gastrectomy compared with open distal gastrectomy for stage I gastric cancer: short-term outcomes from a multicenter randomized controlled trial (KLASS-01). Ann Surg. 2016;263(1):28–35.

    Article  PubMed  Google Scholar 

  8. Kitano S, Shiraishi N, Uyama I, Sugihara K, Tanigawa N. Japanese Laparoscopic Surgery Study Group: a multicenter study on oncologic outcome of laparoscopic gastrectomy for early cancer in Japan. Ann Surg. 2007;245:68–72.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kim HH, Han SU, Kim MC, Hyung WJ, Kim W, Lee HJ, Ryu SW, Cho GS, Song KY, Ryu SY. Long-term results of laparoscopic gastrectomy for gastric cancer: a large-scale case-control and case-matched Korean multicenter study. J Clin Oncol. 2014;32(7):627–33.

    Article  PubMed  Google Scholar 

  10. Sakuramoto S, Kikuchi S, Futawatari N, Moriya H, Katada N, Yamashita K, Watanabe M. Technique of esophagojejunostomy using transoral placement of the pretilted anvil head after laparoscopic gastrectomy for gastric cancer. Surgery. 2010;147:742–7.

    Article  PubMed  Google Scholar 

  11. Nagai E, Ohuchida K, Nakata K, Miyasaka Y, Maeyama R, Toma H, Shimizu S, Tanaka M. Feasibility and safety of intracorporeal esophagojejunostomy after laparoscopic total gastrectomy: inverted T-shaped anastomosis using linear staplers. Surgery. 2013;153(5):732–8.

    Article  PubMed  Google Scholar 

  12. Haverkamp L, Weijs TJ, van der Sluis PC, van der Tweel I, Ruurda JP, van Hillegersberg R. Laparoscopic total gastrectomy versus open total gastrectomy for cancer: a systematic review and meta-analysis. Surg Endosc. 2013;27(5):1509–20. doi:10.1007/s00464-012-2661-1.

    Article  PubMed  Google Scholar 

  13. Jeong GA, Cho GS, Kim HH, Lee HJ, Ryu SW, Song KY. Laparoscopy-assisted total gastrectomy for gastric cancer: a multicenter retrospective analysis. Surgery. 2009;146:469–74.

    Article  PubMed  Google Scholar 

  14. Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer. 2011;14:113–23.

    Article  Google Scholar 

  15. Kong SH, Kim JW, Lee HJ, Kim WH, Lee KU, Yang HK. The safety of the dissection of lymph node stations 5 and 6 in pylorus-preserving gastrectomy. Ann Surg Oncol. 2009;16(12):3252–8.

    Article  PubMed  Google Scholar 

  16. Park DJ, Lee HJ, Jung HC, Kim WH, Lee KU, Yang HK. Clinical outcome of pylorus-preserving gastrectomy in gastric cancer in comparison with conventional distal gastrectomy with Billroth I anastomosis. World J Surg. 2008;32:1029–36.

    Article  PubMed  Google Scholar 

  17. Jiang X, Hiki N, Nunobe S, Fukunaga T, Kumagai K, Nohara K, Sano T, Yamaguchi T. Postoperative outcomes and complications after laparoscopy-assisted pylorus-preserving gastrectomy for early gastric cancer. Ann Surg. 2011;253:928–33.

    Article  PubMed  Google Scholar 

  18. Suh YS, Han DS, Kong SH, Kwon S, Shin CI, Kim WH, Kim HH, Lee HJ, Yang HK. Laparoscopy-assisted pylorus-preserving gastrectomy is better than laparoscopy-assisted distal gastrectomy for middle-third early gastric cancer. Ann Surg. 2014;259(3):485–93.

    Article  PubMed  Google Scholar 

  19. Qiu J, Pankaj P, Jiang H, Zeng Y, Wu H. Laparoscopy versus open distal gastrectomy for advanced gastric cancer: a systematic review and meta-analysis. Surg Laparosc Endosc Percutan Tech. 2013;23:1–7.

    Article  PubMed  Google Scholar 

  20. Hur H, Lee HY, Lee HJ, Kim MC, Hyung WJ, Park YK, Kim W, Han SU. Efficacy of laparoscopic subtotal gastrectomy with D2 lymphadenectomy for locally advanced gastric cancer: the protocol of the KLASS-02 multicenter randomized controlled clinical trial. BMC Cancer. 2015;15:355.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hu Y, Huang C, Sun Y, Su X, Cao H, Hu J, Xue Y, Suo J, Tao K, He X, Wei H, Ying M, Hu W, Du X, Chen P, Liu H, Zheng C, Liu F, Yu J, Li Z, Zhao G, Chen X, Wang K, Li P, Xing J, Li G. Morbidity and mortality of laparoscopic versus open D2 distal gastrectomy for advanced gastric cancer: a randomized controlled trial. J Clin Oncol. 2016;34(12):1350–7.

    Article  PubMed  Google Scholar 

  22. Kodera Y, Fujiwara M, Ohashi N, Nakayama G, Koike M, Morita S, Nakao A. Laparoscopic surgery for gastric cancer: a collective review with meta-analysis of randomized trials. J Am Coll Surg. 2010;211:677–86.

    Article  PubMed  Google Scholar 

  23. Kitano S, Yang HK, editors. Textbook: Laparoscopic gastrectomy for cancer. Tokyo: Springer; 2012.

    Google Scholar 

  24. Diana M, Marescaux J. Robotic surgery. Br J Surg. 2015;102(2):e15–28. doi:10.1002/bjs.9711.

    Article  CAS  PubMed  Google Scholar 

  25. Alemozaffar M, Sanda M, Yecies D, Mucci LA, Stampfer MJ, Kenfield SA. Benchmarks for operative outcomes of robotic and open radical prostatectomy: results from the Health Professionals Follow-up Study. Eur Urol. 2015;67(3):432–8. doi:10.1016/j.eururo.2014.01.039.

    Article  PubMed  Google Scholar 

  26. Han DS, Suh YS, Ahn HS, Kong SH, Lee HJ, Kim WH, Yang HK. Comparison of surgical outcomes of robot-assisted and laparoscopy-assisted pylorus-preserving gastrectomy for gastric cancer: a propensity score matching analysis. Ann Surg Oncol. 2015;22(7):2323–8. doi:10.1245/s10434-014-4204-6.

    Article  PubMed  Google Scholar 

  27. Yang JY, Son YG, Kim TH, Park JH, Huh YJ, Suh YS, Kong SH, Lee HJ, Kim S, Yang HK. Manual ambidexterity predicts robotic surgical proficiency. J Laparoendosc Adv Surg Tech A. 2015;25(12):1009–18. doi:10.1089/lap.2015.0288.

    Article  PubMed  Google Scholar 

  28. Uyama I, Kanaya S, Ishida Y, Inaba K, Suda K, Satoh S. Novel integrated robotic approach for suprapancreatic D2 nodal dissection for treating gastric cancer: technique and initial experience. World J Surg. 2012;36(2):331–7. doi:10.1007/s00268-011-1352-8.

    Article  PubMed  Google Scholar 

  29. Park JY, Kim YW, Ryu KW, Eom BW, Yoon HM, Reim D. Emerging role of robot-assisted gastrectomy: analysis of consecutive 200 cases. J Gastric Cancer. 2013;13(4):255–62. doi:10.5230/jgc.2013.13.4.255.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Hoste G, Van Trappen P. Robotic hysterectomy using the Vessel Sealer for myomatous uteri: technique and clinical outcome. Eur J Obstet Gynecol Reprod Biol. 2015;194:241–4. doi:10.1016/j.ejogrb.2015.09.030.

    Article  PubMed  Google Scholar 

  31. Zhou J, Shi Y, Qian F, Tang B, Hao Y, Zhao Y, Yu P. Cumulative summation analysis of learning curve for robot-assisted gastrectomy in gastric cancer. J Surg Oncol. 2015;111(6):760–7. doi:10.1002/jso.23876.

    Article  PubMed  Google Scholar 

  32. Kim HI, Park MS, Song KJ, Woo Y, Hyung WJ. 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. doi:10.1016/j.ejso.2013.09.011.

    Article  PubMed  Google Scholar 

  33. Hyun MH, Lee CH, Kwon YJ, Cho SI, Jang YJ, Kim DH, Kim JH, Park SH, Mok YJ, Park SS. Robot versus laparoscopic gastrectomy for cancer by an experienced surgeon: comparisons of surgery, complications, and surgical stress. Ann Surg Oncol. 2013;20(4):1258–65. doi:10.1245/s10434-012-2679-6.

    Article  PubMed  Google Scholar 

  34. Woo Y, Hyung WJ, Pak KH, Inaba K, Obama K, Choi SH, Noh SH. Robotic gastrectomy as an oncologically sound alternative to laparoscopic resections for the treatment of early-stage gastric cancers. Arch Surg. 2011;146(9):1086–92. doi:10.1001/archsurg.2011.114.

    Article  PubMed  Google Scholar 

  35. Chuan L, Yan S, Pei-Wu Y. Meta-analysis of the short-term outcomes of robotic-assisted compared to laparoscopic gastrectomy. Minim Invasive Ther Allied Technol. 2015;24(3):127–34. doi:10.3109/13645706.2014.985685.

    Article  PubMed  Google Scholar 

  36. Wall J, Marescaux J. Robotic gastrectomy is safe and feasible, but real benefits remain elusive. Arch Surg. 2011;146(9):1092.

    Article  PubMed  Google Scholar 

  37. Kim HI, Han SU, Yang HK, Kim YW, Lee HJ, Ryu KW, Park JM, An JY, Kim MC, Park S, Song KY, Oh SJ, Kong SH, Suh BJ, Yang DH, Ha TK, Kim YN, Hyung WJ. Multicenter prospective comparative study of robotic versus laparoscopic gastrectomy for gastric adenocarcinoma. Ann Surg. 2016;263(1):103–9. doi:10.1097/sla.0000000000001249.

    Article  PubMed  Google Scholar 

  38. Suda K, Man IM, Ishida Y, Kawamura Y, Satoh S, Uyama I. Potential advantages of robotic radical gastrectomy for gastric adenocarcinoma in comparison with conventional laparoscopic approach: a single institutional retrospective comparative cohort study. Surg Endosc. 2015;29(3):673–85. doi:10.1007/s00464-014-3718-0.

    Article  PubMed  Google Scholar 

  39. Park JY, Ryu KW, Reim D, Eom BW, Yoon HM, Rho JY, Choi IJ, Kim YW. Robot-assisted gastrectomy for early gastric cancer: is it beneficial in viscerally obese patients compared to laparoscopic gastrectomy? World J Surg. 2015;39(7):1789–97. doi:10.1007/s00268-015-2998-4.

    Article  PubMed  Google Scholar 

  40. Park JM, Kim HI, Han SU, Yang HK, Kim YW, Lee HJ, An JY, Kim MC, Park S, Song KY, Oh SJ, Kong SH, Suh BJ, Yang DH, Ha TK, Hyung WJ, Ryu KW. Who may benefit from robotic gastrectomy?: a subgroup analysis of multicenter prospective comparative study data on robotic versus laparoscopic gastrectomy. Eur J Surg Oncol. 2016;42(12):1944–9. doi:10.1016/j.ejso.2016.07.012.

    Article  CAS  PubMed  Google Scholar 

  41. Lee J, Kim YM, Woo Y, Obama K, Noh SH, Hyung WJ. Robotic distal subtotal gastrectomy with D2 lymphadenectomy for gastric cancer patients with high body mass index: comparison with conventional laparoscopic distal subtotal gastrectomy with D2 lymphadenectomy. Surg Endosc. 2015;29(11):3251–60. doi:10.1007/s00464-015-4069-1.

    Article  PubMed  Google Scholar 

  42. Nakauchi M, Suda K, Susumu S, Kadoya S, Inaba K, Ishida Y, Uyama I. Comparison of the long-term outcomes of robotic radical gastrectomy for gastric cancer and conventional laparoscopic approach: a single institutional retrospective cohort study. Surg Endosc. 2016;30(12):5444–52. doi:10.1007/s00464-016-4904-z.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Han-Kwang Yang MD, PhD, FACS, Hon ASA, ESA .

Editor information

Editors and Affiliations

1 Electronic Supplementary Material

Robot assisted laparoscopic gastrectomy (MP4 1676889 kb)

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Kong, SH., Lee, HJ., Yang, HK. (2017). Laparoscopic and Robot Assisted Gastrectomy. In: Cuesta, M. (eds) Minimally Invasive Surgery for Upper Abdominal Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-54301-7_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-54301-7_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54300-0

  • Online ISBN: 978-3-319-54301-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics