J.Jpn. Surg. Soc.. 123(6): 525-530, 2022

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Feature topic

ROBOTIC GASTRECTOMY: CURRENT STATUS AND FUTURE PERSPECTIVES

Robotic surgery (RS) has spread with the expansion of surgical procedures and has been covered by the Japanese insurance system since April 2018. It has been reported that postoperative complications of RS are lower than those of laparoscopic surgery (LS) in terms of the incidence of intraabdominal infectious complications and pancreatic fistula in Japan. A randomized controlled trial (JCOG1907) is underway to examine the superiority of RS over LS. The results of this trial are attracting attention in order to determine the true usefulness of RS. The most important feature of RS is the improvement of anatomic recognition capability by means of highly magnified 3D high-definition images. By observing the patient closely and reflecting the basic surgical concepts of “incision,” “dissection” and “resection” in RS, all procedures can be performed with the same concept. The multiarticulated function and motion scale lead to precise techniques, and the Tile Pro and Firefly functions can be utilized to ensure safer, more reliable surgery. In the future, RS is expected to lead to safe, stable outcomes in highly advanced gastric cancer. At the same time, the widespread use of RS requires the establishment of a management responsibility and educational system for instructors at each institution.

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