Lymphadenectomy using two instrument arms during robotic surgery for gastric cancer: A strategy to facilitate reduced-port robotic gastrectomy

Yong Yeup Kim, Yoontaek Lee, Chang Min Lee, Sungsoo Park

Research output: Contribution to journalArticle

Abstract

Background: Three instrument arms are used in the current form of reduced-port robotic gastrectomy (RPRG) for gastric cancer. Based on our experience in performing reduced-port laparoscopic gastrectomy (RPLG), we have recently performed RPRG using two instrument arms. Methods: From February 2018 to January 2019, we performed RPRG using two instrument arms for gastric cancer. One endoscope arm and two instrument arms of da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) were applied in robotic lymphadenectomy. A commercial multi-lumen single-port trocar was used for the endoscopy port. Results: A total of 18 patients underwent the planned robotic surgery using two instrument arms. Median operation time was 288.5 (213.0–446.0) minutes, and median hospital stay was 11.0 (7–18) days. Four patients experienced postoperative complications: one Clavien-Dindo grade IIIa, and the other three grade II. No mortality was reported. The number of retrieved lymph nodes did not differ between patients who underwent RPRG and RPLG (p = 0.412). Conclusion: Gastric cancer surgery using two instrument arms of a robotic surgical system can be performed by surgeons with expertise of RPLG. If this technique is successfully introduced in robotic surgery, it is expected to shorten the path to pure single-port robotic gastrectomy.

Original languageEnglish
JournalAsian Journal of Surgery
DOIs
Publication statusPublished - 2019 Jan 1

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Robotics
Gastrectomy
Lymph Node Excision
Stomach Neoplasms
Endoscopes
Surgical Instruments
Endoscopy
Length of Stay
Lymph Nodes
Mortality

Keywords

  • Gastric cancer
  • Lymphadenectomy
  • Robotic gastrectomy

ASJC Scopus subject areas

  • Surgery

Cite this

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title = "Lymphadenectomy using two instrument arms during robotic surgery for gastric cancer: A strategy to facilitate reduced-port robotic gastrectomy",
abstract = "Background: Three instrument arms are used in the current form of reduced-port robotic gastrectomy (RPRG) for gastric cancer. Based on our experience in performing reduced-port laparoscopic gastrectomy (RPLG), we have recently performed RPRG using two instrument arms. Methods: From February 2018 to January 2019, we performed RPRG using two instrument arms for gastric cancer. One endoscope arm and two instrument arms of da Vinci{\circledR} Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) were applied in robotic lymphadenectomy. A commercial multi-lumen single-port trocar was used for the endoscopy port. Results: A total of 18 patients underwent the planned robotic surgery using two instrument arms. Median operation time was 288.5 (213.0–446.0) minutes, and median hospital stay was 11.0 (7–18) days. Four patients experienced postoperative complications: one Clavien-Dindo grade IIIa, and the other three grade II. No mortality was reported. The number of retrieved lymph nodes did not differ between patients who underwent RPRG and RPLG (p = 0.412). Conclusion: Gastric cancer surgery using two instrument arms of a robotic surgical system can be performed by surgeons with expertise of RPLG. If this technique is successfully introduced in robotic surgery, it is expected to shorten the path to pure single-port robotic gastrectomy.",
keywords = "Gastric cancer, Lymphadenectomy, Robotic gastrectomy",
author = "Kim, {Yong Yeup} and Yoontaek Lee and Lee, {Chang Min} and Sungsoo Park",
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AU - Lee, Chang Min

AU - Park, Sungsoo

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N2 - Background: Three instrument arms are used in the current form of reduced-port robotic gastrectomy (RPRG) for gastric cancer. Based on our experience in performing reduced-port laparoscopic gastrectomy (RPLG), we have recently performed RPRG using two instrument arms. Methods: From February 2018 to January 2019, we performed RPRG using two instrument arms for gastric cancer. One endoscope arm and two instrument arms of da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) were applied in robotic lymphadenectomy. A commercial multi-lumen single-port trocar was used for the endoscopy port. Results: A total of 18 patients underwent the planned robotic surgery using two instrument arms. Median operation time was 288.5 (213.0–446.0) minutes, and median hospital stay was 11.0 (7–18) days. Four patients experienced postoperative complications: one Clavien-Dindo grade IIIa, and the other three grade II. No mortality was reported. The number of retrieved lymph nodes did not differ between patients who underwent RPRG and RPLG (p = 0.412). Conclusion: Gastric cancer surgery using two instrument arms of a robotic surgical system can be performed by surgeons with expertise of RPLG. If this technique is successfully introduced in robotic surgery, it is expected to shorten the path to pure single-port robotic gastrectomy.

AB - Background: Three instrument arms are used in the current form of reduced-port robotic gastrectomy (RPRG) for gastric cancer. Based on our experience in performing reduced-port laparoscopic gastrectomy (RPLG), we have recently performed RPRG using two instrument arms. Methods: From February 2018 to January 2019, we performed RPRG using two instrument arms for gastric cancer. One endoscope arm and two instrument arms of da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, CA, USA) were applied in robotic lymphadenectomy. A commercial multi-lumen single-port trocar was used for the endoscopy port. Results: A total of 18 patients underwent the planned robotic surgery using two instrument arms. Median operation time was 288.5 (213.0–446.0) minutes, and median hospital stay was 11.0 (7–18) days. Four patients experienced postoperative complications: one Clavien-Dindo grade IIIa, and the other three grade II. No mortality was reported. The number of retrieved lymph nodes did not differ between patients who underwent RPRG and RPLG (p = 0.412). Conclusion: Gastric cancer surgery using two instrument arms of a robotic surgical system can be performed by surgeons with expertise of RPLG. If this technique is successfully introduced in robotic surgery, it is expected to shorten the path to pure single-port robotic gastrectomy.

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KW - Lymphadenectomy

KW - Robotic gastrectomy

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