Da Vinci Surgical Research Articles

Comparison of Two Simulation Systems to Support Robotic-Assisted Surgical Training: A Pilot Study (Swine Model)

To compare the efficacy of simulation-based training between the Mimic dV- Trainer and traditional dry lab da Vinci robot training. A prospective randomized study analyzing the performance of 20 robotics-naive participants. Participants were enrolled in an online da Vinci Intuitive Surgical didactic training module, followed by training in use of the da Vinci standard surgical robot. Spatial ability tests were performed as well. Participants were randomly assigned to 1 of 2 training conditions: performance of 3 Fundamentals of Laparoscopic Surgery dry lab tasks using the da Vinci or performance of 4 dV-Trainer tasks. Participants in both groups performed all tasks to empirically establish proficiency criterion. Participants then performed the transfer task, a cystotomy closure using the daVinci robot on a live animal (swine) model. The performance of robotic tasks was blindly assessed by a panel of experienced surgeons using objective tracking data and using the validated Global Evaluative Assessment of Robotic Surgery (GEARS), a structured assessment tool. No statistically significant difference in surgeon performance was found between the 2 training conditions, dV-Trainer and da Vinci robot. Analysis of a 95% confidence interval for the difference in means (-0.803 to 0.543) indicated that the 2 methods are unlikely to differ to an extent that would be clinically meaningful. Based on the results of this study, a curriculum on the dV- Trainer was shown to be comparable to traditional da Vinci robot training. Therefore, we have identified that training on a virtual reality system may be an alternative to live animal training for future robotic surgeons.

Board #102 - Research Abstract Comparing Standard Vs. Video-Based Teaching For Ultrasound-Guided Internal Jugular Central Venous Catheter Access For 4th Year Medical Students (Submission #8825)

Hypothesis Small group instruction of procedural skills is faculty intensive, and presents challenges when multiple instructors are required to train large numbers of learners. At our institution, incoming residents who want vascular access privileges undergo a protocolized ultrasound guided central line training program. Senior medical students have requested similar training, but faculty resources are not adequate to accommodate the large number of interested students. To meet student needs, we developed a self-directed video-based learning module to teach the skill of ultrasound guided internal jugular access (US-IJ) to our institutional standards. The objective of this study is to evaluate the efficacy of teaching US-IJ using high quality video compared to standard faculty led US-IJ teaching. The video enables learners to self-pace with the ability to rewind, pause, and fast-forward individual video segments. Methods Randomized controlled trial in the simulation center of an academic center, during a four-week senior medical student capstone course in March 2014. Each student completed a peripheral US IV training session and an online module. Subjects were randomly assigned to either faculty-led (standard) or video-guided (intervention) three-hour teaching sessions using vascular access manikins and ultrasound machines. Intervention group used an interactive video detailing procedural steps, following a standard checklist (55 items) established by our institution. The intervention group had the chance to interact with a faculty at the end of their session to address specific questions only. At the conclusion of each session, all students independently completed a video-recorded performance station of US-IJ placement. Two faculty instructors scored videos based on the checklist. Scores were compared using t-test. An independent instructor scored 20% of each group to calculate inter-rater reliability. Results Thirty-two MS-IV were enrolled in the study, 16 in each group. Five students were excluded (four did not attend and one encountered ultrasound recording failure). Fourteen students in the video group and 13 students in the standard group were included. The intervention group performed significantly more checklist items correctly (90%, 95%CI 86.5-93%) than did the standard group (81%, 95% CI 77.6-84.2%). (P = 0.0003) Conclusion US-IJ training using self-directed high quality video guided instruction may be superior to standard, faculty-guided instruction. Use of video eliminates instructional variability, decreases the demand on faculty time, and enables individual learners to work at their own pace. Furthermore, a larger number of learners can be accommodated. This is crucial in places where having continuous, standard, and high-quality instruction is considered a challenging problem. We recommend a larger study of vascular access training using video guidance be conducted. Disclosures The CLASS Center has received support in the form of equipment loans from Karl Storz. Claudia Ranniger owns stock in Intuitive Surgical (manufacturer of DaVinci Robot).

The DA Vinci Surgical System: A Rapid Review of the Clinical and Economic Evidence.

The DA Vinci Surgical System: A Rapid Review of the Clinical and Economic Evidence.

AB15. Anatomy of prostate and surrounding tissue in the application of radical prostatectomy.

Surgical technology, especially da Vinci Surgical System, has reinforced people’s understanding of the structure and anatomy of organ under 3D imaging technology in clinical application. The anatomy of prostate and surrounding tissue has features of multiple-layers and great variation. So, application of 3D imaging in anatomy has new progress and positive clinical anticipated effect in radical prostatectomy, especially for complete dissection of tumor, urinary continence and protection of sexual function. Therefore, 3D imaging technology provides an innovative visual experience, and it will create a promising prospect in the preciseness of surgical operation as more experiences accumulated in the future.

Augmented‐reality‐based skills training for robot‐assisted urethrovesical anastomosis: a multi‐institutional randomised controlled trial

To validate robot-assisted surgery skills acquisition using an augmented reality (AR)-based module for urethrovesical anastomosis (UVA). Participants at three institutions were randomised to a Hands-on Surgical Training (HoST) technology group or a control group. The HoST group was given procedure-based training for UVA within the haptic-enabled AR-based HoST environment. The control group did not receive any training. After completing the task, the control group was offered to cross over to the HoST group (cross-over group). A questionnaire administered after HoST determined the feasibility and acceptability of the technology. Performance of UVA using an inanimate model on the daVinci Surgical System (Intuitive Surgical Inc., Sunnyvale, CA, USA) was assessed using a UVA evaluation score and a Global Evaluative Assessment of Robotic Skills (GEARS) score. Participants completed the National Aeronautics and Space Administration Task Load Index (NASA TLX) questionnaire for cognitive assessment, as outcome measures. A Wilcoxon rank-sum test was used to compare outcomes among the groups (HoST group vs control group and control group vs cross-over group). A total of 52 individuals participated in the study. UVA evaluation scores showed significant differences in needle driving (3.0 vs 2.3; P = 0.042), needle positioning (3.0 vs 2.4; P = 0.033) and suture placement (3.4 vs 2.6; P = 0.014) in the HoST vs the control group. The HoST group obtained significantly higher scores (14.4 vs 11.9; P 0.012) on the GEARS. The NASA TLX indicated lower temporal demand and effort in the HoST group (5.9 vs 9.3; P = 0.001 and 5.8 vs 11.9; P = 0.035, respectively). In all, 70% of participants found that HoST was similar to the real surgical procedure, and 75% believed that HoST could improve confidence for carrying out the real intervention. Training in UVA in an AR environment improves technical skill acquisition with minimal cognitive demand.

The safety and effectiveness of Da Vinci surgical system compared with open surgery and laparoscopic surgery: a rapid assessment

The primary objectives of this rapid assessment were to assess the clinical evidence of Da Vinci surgical system (DVSS) comparing with open procedures and laparoscopic procedures, and in order to provide the evidence for health decision makers and clinician. A comprehensive search of electronic databases (EMbase, PubMed, The Cochrane Library, Web of Science, CNKI, VIP, CBM and Wanfang) and HTA websites were completed up to 9 October, 2013. Two reviews (Jiajie Yu and Yingqiang Wang) independently extracted data of the manuscripts, and assessed quality of included studies using AMSTAR tools. Qualitative description and GRADE were used to report the outcomes and evidence quality. A total of 17 studies were included: 3 were HTA and 14 were SR/meta-analysis. The included studies focused on prostatectomy, nephrectomy, hysterectomy colorectal surgery, and cardiac surgery. DVSS was shown to be associated with statistically significant reduction in length of hospital stay, blood loss, and transfusion rate compared with open and laparoscopic surgery, but increase in operative time when compared with open surgery. Based on the evidence included in this rapid assessment, DVSS has a limited impact on several clinical outcomes. Considering no available data from randomized controlled trials and much higher cost, decisions will be complex and need to be made carefully. Decision makers should cut down the quantity of purchasing and reasonable allocate them.

V4-05 ROBOT-ASSISTED LAPAROSCOPIC RESECTION OF BLADDER DIVERTICULA

You have accessJournal of UrologyAdrenal/Robotics1 Apr 2014V4-05 ROBOT-ASSISTED LAPAROSCOPIC RESECTION OF BLADDER DIVERTICULA Jan Lukas Hohenhorst, Darko Kroepfl, Anne Pailliart, Heinrich Loewen, and Michael Musch Jan Lukas HohenhorstJan Lukas Hohenhorst More articles by this author , Darko KroepflDarko Kroepfl More articles by this author , Anne PailliartAnne Pailliart More articles by this author , Heinrich LoewenHeinrich Loewen More articles by this author , and Michael MuschMichael Musch More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1538AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Diverticulectomy (DIV) is indicated for large diverticula (DI) associated with incomplete emptying, urinary tract infection, bladder calculi, or endoscopically non-treatable tumours. With the evolution of minimally invasive (MI) technology, even complex DI can be managed with MI procedures. In this video we describe robotic (ROB) approaches to surgery of the DI with special attention paid to techniques, complications and outcomes. Methods We have performed, and described, a DIV procedure using the daVinci robot. The steps needed to identify, approach and resect the DI and to perform closure of the bladder are presented. A retrospective review has been carried out with 14 consecutive patients (P) who underwent ROB-DIV. Results The steps of the ROB-DIV are illustrated and described in our video. Prior to port placement, cystoscopy is performed for ureteral catheterization and to determine the relationship of the ureteral orifices (UO) and DI mouth. The ports are placed as for radical prostatectomy. The surgeon first incises the peritoneum medially of the obliterated medial umbilical ligament and identifies the ductus deferens and the ureter. The bladder is then filled, which permits identification of the DI. The DI neck is then identified, opened and transsected. In the case of a close proximity of the UO to the DIV mouth, a transvesical incision superior to the DI mouth or even on the contralateral side allows easier UO identification and preservation, ureteral catheterisation and ureteral reimplantation if necessary. The plane is then developed between the DI and the surrounding tissue and the DIV is completed. The bladder is closed in two layers. Between 2009 and 20013 14 consecutive patients underwent ROB-DIV with this procedure. There were no intraoperative complications. Major complications (one grade IIIa and one grade IVa according to the Clavien classification) occurred in 2 patients within 90 days of surgery. The median hospital stay after surgery was 8 days. At a median follow-up time of 20.8 months, all patients remained without signs of DI recurrence and were asymptomatic. Conclusions In our hands the ROB-DIV is a treatment of choice for the treatment of DI in patients who would otherwise be treated with open surgery. This video presents our technique for ROB-DIV using a trans- or extravesical approach to the DIV mouth. We feel that in cases with a close proximity of the UO to the DIV mouth, the transvesical approach allows easier UO identification and preservation, ureteral catheterisation and ureteral reimplantation if necessary. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e552 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jan Lukas Hohenhorst More articles by this author Darko Kroepfl More articles by this author Anne Pailliart More articles by this author Heinrich Loewen More articles by this author Michael Musch More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

A Tale of Two Robots

Although almost 9 years have passed since the FDA approved the da Vinci Surgical System for use in gynecologic surgery, questions and controversy about

Raven surgical robot training in preparation for da vinci.

The rapid adoption of robotic assisted surgery challenges the pace at which adequate robotic training can occur due to access limitations to the da Vinci robot. Thirty medical students completed a randomized controlled trial evaluating whether the Raven robot could be used as an alternative training tool for the Fundamentals of Laparoscopic Surgery (FLS) block transfer task on the da Vinci robot. Two groups, one trained on the da Vinci and one trained on the Raven, were tested on a criterion FLS block transfer task on the da Vinci. After robotic FLS block transfer proficiency training there was no statistically significant difference between path length (p=0.39) and economy of motion scores (p=0.06) between the two groups, but those trained on the da Vinci did have faster task times (p=0.01). These results provide evidence for the value of using the Raven robot for training prior to using the da Vinci surgical system for similar tasks.

Comparison of Knot Tying in Robotic, Laparoscopic, and Open Surgery: Robotic Knots as Tight as, but More Secure than, Open Knots

Objective: Robotic surgery may have many potential benefits for the surgeon. In an effort to evaluate the surgical performance, standard laparoscopy, DaVinci robot (Intuitive Surgical, Sunnyvale, CA), and standard open knot tying by two experienced gynecologic surgery trainees, were compared. Design, Materials, and Methods: Two gynecologic surgeons who were trained in laparoscopic surgery were asked to tie knots with 2-0 VICRYL™ sutures under controlled conditions using the DaVinci robot, a laparoscopic simulator stack, and by hand. The procedures were filmed and timed, and the knots collected for further testing using a tensiometer. The tensiometer was used to check the tightness and security of the knot. Results: The robotic knots (p=0.021) and open knots (p=0.0001) were both significantly tighter than the laparoscopic knots. The open knot tying was much faster than either the robotic or the laparoscopic knot tying. There was no statistically significant difference between the laparoscopic and robotic knot ties. There was no statistical difference in security in robotic versus laparoscopic knots or in laparoscopic versus open knots. The robotic knots were more secure than the open knots (odds ratio=0.351; 95% confidence interval [CI]=0.152–0.814). Conclusions: Robotic knot tying was as quick as and tighter than laparoscopic knot tying, and more secure but slower than open tying. The lack of haptic feedback can lead to snapped knots as a result of excessive force. (J GYNECOL SURG 26:287)

Clinical study of robot-assisted laparoscopic surgery for complicated adrenal tumors that unfit for conventional laparoscopic adrenalectomy

Objective To discuss the feasibility,safety and efficacy of robot-assisted laparoscopic adrenalectomy(RALA) in the treatment of complicated adrenal tumors that unfit for conventional laparoscopic adrenalectomy.Methods Fourteen patients with complicated adrenal tumors underwent RALA from August 2012 to March 2013.Five patients were male and 9 patients were female.Preoperative ultrasound and CT scan indicated that tumors of 10 patients were in the left side,and 4 in the right.Images showed that the maximum diameters of the tumors were 2.5-10.0 cm,with an average of 5.2 cm.The reasons to choose RALA were as follows:large tumors (≥5 cm) in 9 cases,patients' overweight or obesity in 7 cases,the need or the desire to save the normal adrenal tissue in a great extent in 4 cases,tumors compressing large vessels or important organs in 3 cases,the possibility that the tumor may be a metastasis in 1 case.Six cases had 2 or more reasons described above.All surgeries were pedormed by lateral transperitoneal approach started with the paracolic gutter.General anesthesia was used in all cases.Four trocars (3 robotic arms and 1 assistant port) were used in the left-sided adrenalectomies and 5 trocars (3 robotic arms and 2 assistant ports) were used in the right-sided adrenalectomies.Results All the operations were successful without conversion to open surgery.The mean docking time of da Vinci surgical system was 10 min.The operative time was 30-120 min,with an average of 73 min.The estimated blood loss was 10-400 ml,with an average of 111 ml.No transfusion was needed during the surgeries.The length of postoperative hospital stay was 4.0-10.0 d,with an average of 5.7 d.Postoperative pathology showed pheochromocytoma in 3 cases (including 1 paraganglioma),macronodular adrenal hyperplasia in 1 case,adenoma with hyperplasia in 2 cases,adenoma in 4 cases,myelolipoma in 1 case,metastatic tumor in 1 case,large cyst in 1 case,calcified cyst in 1 case.No recurrence was found during the follow-up of 2 to 10 months.Conclusion For patients with adrenal tumors that unfit for conventional laparoscopic surgery,RALA may provide an alternative option for the advantage of delicate manipulation and three-dimensional magnifying image. Key words: Robotics; Laparoscopes; Adrenal gland neoplasms; Adrenalectomy

Robotic‐Assisted Lingual Tonsillectomy in the Pediatric Population

Objectives: Assess the feasibility and outcomes of robotic-assisted lingual tonsillectomy (RALT) in the pediatric population. Methods: Retrospective medical chart review performed using a tertiary care children’s hospital database identified 16 pediatric patients who underwent RALT from March 2011 through December 2012. Demographic data, comorbidities, robot docking time, operative time, surgical blood loss, and postoperative course, including complications in the immediate and longer-term postoperative period, were collected and analyzed. Results: All patients successfully underwent RALT using the daVinci Surgical Robot (Intuitive Surgical, Sunnyvale, CA). Endotracheal intubation was used in all cases and did not interfere with visualization of the oropharynx. Optimal retraction allowed visualization of pertinent structures and maximized transoral access. A significant learning curve from the first 5 surgical cases to subsequent cases with respect to robot docking time and surgical blood loss was observed (9 versus 3 minutes and 7.4 versus 3.2 ml respectively, P < .05). Operative time, estimated blood loss, and postoperative complication profile are within the expected and acceptable limitations for performing lingual tonsillectomy in the pediatric population. Conclusions: Technologic advances have allowed miniaturization of robotic instrumentation and have expanded the scope of surgical options for the pediatric airway. RALT is well-tolerated and can be performed in the pediatric population with excellent success. It should be considered a feasible option for implementation at an institution-based level.

Anesthesia management of artificial intelligence-assisted surgery

Background With the development of minimally invasive surgery in our country,to da Vinci robotic surgical system has been developed to carry out complex and difficult surgery.As the representative of artificial intelligence-assisted surgery systems in clinical surgery more widely,prolonged anesthesia artificial intelligence assisted surgery increases the complexity of the anesthesia presents new challenges.Objective This paper analyzed and summarized the anesthetic management strategies of artificial intellgence-assisted surgery systems.Content This paper reviewed preoperative evaluation,type of anesthesia and anesthetic management of the central nervous system and other aspects in patients in artificial intelligence surgical system.Trend Artificial intelligenc-assisted surgery is an important advance in minimally invasive surgery.The effects about respiratory,circulatory and nervous system need to be further summarized. Key words: Anesthesia; da Vinci Surgical System; Artificial intelligence assisted surgery system

Teaching robotic surgery skills: comparing the methods of generalists and subspecialists

To compare opinions of general and subspecialty obstetricians and gynecologists regarding teaching robotic surgery (RS) to residents. After obtaining IRB approval, 2189 gynecologic surgeons trained on the DaVinci Surgical System® (Intuitive Surgical, Sunnydale, CA) were asked to complete an online survey. Anonymous responses were obtained and compared using the chi-squared test, including opinions on training residents in RS. Of these 303 respondents, 161 practiced general obstetrics and gynecology ('generalists'), and 138 were self-described 'subspecialists' (+/- fellowship training). The majority of subspecialists (82%) taught residents, and 63% allowed resident participation. Only 44% of generalists taught residents, and 36% allowed participation. Regarding ideal RS training time, generalists favored residency (39%), while subspecialists favored fellowship. (46%, P < 0.001) CONCLUSIONS: While many generalists and subspecialists incorporate training residents into their robotic cases, there is still disparity regarding the extent of participation. Standardized training curriculums should be a goal of residencies with RS.

A Case of Silicone Mesh Extrusion Into the Bladder Associated With Robotic Sacrocolpopexy

Over the past several years, the daVinci robot has been used in gynecologic surgery as a new surgical approach. The literature is being slowly populated with pros and cons of this technology. We report a 60-year-old woman with a history of pelvic organ prolapse who had a robotic sacrocolpopexy. She presented with mesh extrusion into her vagina, which was removed by exploratory laparotomy. Two years later, she presented with mesh erosion into her bladder, which was removed. This case report provides an example of significant mesh complication associated with robotic sacrocolpopexy 4 years after surgery and then again 2 years later.

Transoral robotic resection of selected parapharyngeal space tumors

Currently, transoral robotic surgery (TORS) with the daVinci robot is mainly used for squamous cell carcinoma of the oropharynx and supraglottic larynx. The safety, efficacy, and functional outcomes regarding this approach have previously been described. In addition to transoral resection of squamous cell carcinoma, we have found use for this technique in removing selected tumors of the parapharyngeal space. Three patients with benign or malignant tumors of the parapharyngeal space who underwent successful transoral resection using the daVinci robot were included in the study. In all three cases, complete tumor excision was achieved without any complication. None required conversion to an open procedure. Mean TORS operative time and intraoperative blood loss were 16.3 min and 4.7 mL, respectively. Inadequate oral exposure, involvement of the internal carotid artery, limited cervical spine mobility and large tumor size are the main limitations of this approach. Result indicates that magnified view, 3D visualization with the combination of the transoral robotic experience, allow en bloc resection of selected parapharyngeal space tumors located medial to the carotid sheath.

Clinical analysis of robot-assisted laparoscopic radical cystectomy with urinary diversion

Objective To investigate the clinical feasibility of robotic-assisted laparoscopic radical cystectomy (RARC) by da Vinci surgical system and to summarize the operative technique and outcomes.Methods From December 2007 to March 2012,22 patients (20 males and 2 females) with the bladder urothelial carcinomas were enrolled.Patient age was from 37 -72 years (rnean 62 years) ; the body mass index was 22.5 - 30.1 kg/m2 ( mean 26.1 kg/m2 ) ; and the American Society of Anesthesiologists score was 1 -2. All patients were diagnosed preoperatively with muscle -invasive or high-risk non-muscle-invasive bladder urothelial carcinomas in cystoscopic biopsy.There were no adjacent organ infiltration,pelvic lymph node involvement or distant metastasis found on preoperative examinations.The clinical stage of all cases was under T2 N0 M0.Patients were under general anesthesia for RARC with urinary diversion.Extracorporeal urinary diversions (orthotopic ileal neobladder for 2 patients and ileal conduit urinary diversion for 13 patients)were performed on 15 patients and intracorporeal urinary diversions ( ileal conduit urinary diversion for 2 patientsand orthotopic ileal neobladder for 5 patients) were performed on 7 patients. Results All RARC procedure were completed on patients as planned.The operative time was 300 - 667 min ( mean 480 min)with estimated blood loss of 100 - 1200 ml (mean 550 ml),and the number of removed lymph nodes was 6 -25 (mean 15). All patients resumed ambulation on the 2nd to 3rd day postoperatively,and bowel function recovered on the 3rd or 4th day postoperatively.The length of hospital stay was 8 - 35 days ( mean 16 days).For patients underwent orthotopic ileal neobladder,the ileoureteral stents and the urethral catheter were removed 1 month after a cystogram confirming watertight healing.During the follow up of 4 -49 months (mean 32 months),2 patients had disease recurrence and 1 patient died of disease development and 2 patients had developed hydronephrosis.The other patients were with good urinary continence and normal renal functions. Conclusions RARC with urinary diversion are feasible and safe treatment option for bladder urothelial carcinoma.This technique will be more popular with more extensive surgical experiences and large randomized clinical trials. Key words: Robotic; Cytectomy; Urinary diversion

DaVinci Surgical System Arm Drapes

DaVinci Surgical System Arm Drapes

Minimally Invasive Approach to an 18cm Broad Ligament Myoma

Large broad ligament myomas affect the quality of life of patients causing pelvic pain, dyspareunia, bleeding, urinary frequency and changes in bowel habits. Surgical approaches to removing leiomyomas can be done via laparotomy, laparoscopy or the daVinci robot. The route of surgery is influenced by location and size of leiomyomas, prior medical and surgical history, concomitant pathology, patient preference, desire for future fertility and the surgeon's experience. Length of hospital stay, post-operative pain, infection risk and anticipated blood loss are also considerations in determining the appropriate surgical approach.

Application of surgical robotic system in patients with gastric cancer: a report of 120 cases

To evaluate the safety, feasibility, and efficacy of robotic gastrectomy for gastric cancer using da Vinci surgical system. A total of 120 patients who underwent robotic gastrectomy using da Vinci surgical system for gastric cancer from May 2010 to April 2012. Data regarding surgical and early oncological outcomes were systematically collected in a specific database for statistical analysis. There were 74 males and 46 females, with a mean age of 58.5 (22-80) years old. The type of robotic operation included 62 distal subtotal gastrectomies, 35 total gastrectomies, and 23 proximal gastrectomies. Reconstruction of the alimentary tract was achieved using extracorporeal method through a minilaparotomy in 55 cases, and intracorporeal robot-sewn anastomosis in 65 cases. There was 1 conversion (0.9%). The operative time was (245±50) min and the docking time (17±5) min. The blood loss was (70±45) ml. The number of harvested lymph nodes was 22.5±10.7. The resection margins were negative in all surgical specimens. The postoperative pathological stage consisted of stage I B in 24 cases, stage II in 28, stage III A in 47, and stage III B in 21. Six patients (5%) developed postoperative complication including 1 case of duodenal stump leakage, 2 cases of esophagus-gastric leakage, 1 case of small bowel obstruction, 1 case of delayed gastric emptying, and 1 case of abdominal bleeding. All the complications were cured by reoperation or conservative therapy, and there were no postoperative 30-day deaths. The postoperative hospital stay was (6.3±2.6) days. Robotic gastrectomy for the treatment of gastric cancer is a feasible and safe procedure, and is advantageous in terms of lymphadenectomy and alimentary tract reconstruction.