Abstract
Gastrectomy with extended lymph node dissection is the only standard curative treatment for locally advanced gastric cancer. The development of laparoscopic surgery has changed much in gastric cancer surgery over recent decades, and robotic technology tried to overcome the limitations of laparoscopic surgery. However, basic principle of robotic gastrectomy is same as open gastrectomy. Then, what is standard gastrectomy? The answer for this question is not simple because the standard D2 gastrectomy has evolved over 60 years. Currently, it is believed important to keep “surgical plane based on embryological origin” to perform an en bloc dissection of mesogastrium. The difficulty comes from the fact that pancreas is in the middle of the mesogastrium and should be saved with major vessels like common hepatic artery, splenic artery, and splenic vein. Suprapancreatic nodal dissection must be the most challenging part of the surgery with laparoscopic approach due to the technological limitation. Robotic surgery could have a role in this technological challenge of laparoscopic gastric surgery.
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References
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Laparoscopic robot-assisted Billroth I anastomosis
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Kim, YW., Han, W.H. (2021). Robotic Distal Gastrectomy for Gastric Cancer. In: Asunción Acosta, M., Cuesta, M.A., Bruna, M. (eds) Atlas of Minimally Invasive Techniques in Upper Gastrointestinal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-55176-6_36
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DOI: https://doi.org/10.1007/978-3-030-55176-6_36
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