| Robotic surgery is a successful approach to the management of patients with gastric cancer. The widespread application of the laparoscopic gastric cancer surgery, however, has been limited to due to the technical complexity of a gastrectomy with extended lymphadenectomy and concerns about maintaining oncologic principles during the laparoscopic procedures. Surgeons are adapting robotic technology to assist in the technically challenging procedure of gastrectomy with extended lymphadenectomy. The advantages of the 3D magnified view, the tremor filtering, and articulating instruments along with the surgeon's ability to control 4-arms provide the surgeon with superior control. Robotic gastric cancer surgery has been demonstrated to be safe and feasible with an expected shorter learning curve. The data from retrospective studies and limited prospective comparisons support the short-term benefits of robotic gastrectomy to be comparable to that of laparoscopy. Moreover, adherence to the oncologic principles of gastric cancer treatment, such as no touch technique, negative margins, and adequate LN dissection is being practiced. Debate continues on the efficiency of robotic gastrectomies, however, as the disadvantages such as longer operative time, limited training opportunities, and increased cost of the robotic system fuel the controversies. Robotic gastrectomy is a sound option for the surgical treatment of gastric cancer with the potential for great benefit. As surgeons become increasingly sophisticated in the application of emerging robotic technology, robotic treatment of gastric cancer will evolve in the years to come. |
