Robotic surgery for gastric cancer

Minimally invasive surgery (MIS) for gastric cancer has been gaining popularity. Although many surgeons have reported the feasibility of MIS for gastric cancer, difficulties in standard lymph node dissection and anastomoses during laparoscopic procedures have hindered the widespread use of this technique. To overcome these difficulties, a robotic system has been adopted and its feasibility and safety have been shown. However, robotic surgery for gastric cancer has shown few definite advantages over conventional laparoscopy so far. In addition, longer operation time and much higher cost for this procedure are consistently noted. Recently, some retrospective comparative studies have reported benefits of robotic surgery over laparoscopic gastrectomy such as more complete D2 lymph node dissection for advanced gastric cancer, less blood loss, and shorter learning curves. For the wider spread of robotic surgery for gastric cancer, well designed studies are required to verify patients' secondary advantages, the cost benefit trade-off, and oncologic outcomes.