Robotic versus laparoscopic gastrectomy

Abstract

The advent and steady refinement of new technologies decisively influences the surgical treatment of solid cancers. Minimally invasive surgery, both laparoscopic and robotic, has become very popular. Improving the patient’s quality of life substantially, this patient-friendly surgical approach currently is preferred by a steadily increasing number of patients. Laparoscopic surgery is a standard of care at many specialized institutions for several solid cancer types. According to evidence-based medicine, high-quality reliable data from randomized controlled trials and metaanalyses have demonstrated the safety and efficacy of laparoscopic surgery for the treatment of colorectal cancer [1, 2]. However, laparoscopic gastrectomy has not been adopted as a routine surgical procedure to date, except in Asian countries, particularly Korea [3]. The Da Vinci robotic system has been developed toward a step further and is gaining in popularity among patients and clinicians. The Da Vinci system may provide more accurate, precise, and anatomic resection of the primary tumor and perhaps also of regional lymph nodes than laparoscopic resection or open surgery, particularly for specific tumor locations. For example, for rectal cancer, robotic surgery appears to be superior to laparoscopic surgery. Indeed, due to the anatomic location of rectal cancer in the pelvis, a precise total mesorectal excision and anatomic structure-based surgery preserving the function