Current Status and Future Prospects of Robot-Assisted Gastric Cancer Surgery in Japan

Since the mid-2000s, robot-assisted gastrectomy for gastric cancer has been attracting attention in Asia, especially in Korea, and is now widely performed. In Japan, a prospective study of advanced medical treatment B（” Sensiniryo B “ in Japanese ） demonstrated that robot-assisted surgery significantly reduced postoperative complications (CD grade 3 or higher) compared with laparoscopic surgery, and the procedure was covered by public insurance in April 2018. Since then, similar results have been reported in several clinical trials. In an additional study of advanced medical treatment B, a propensity score matched analysis was performed, and the 3-year survival rate was significantly better in the robotic group. Furthermore, a cost-effectiveness study showed that robotic surgery was more effective than laparoscopic surgery. Therefore, there is no doubt that a paradigm shift from laparoscopic to robotic surgery will occur in gastric cancer surgery. In the future, it is important to share the excellent robotic gastric cancer surgery technology in Japan across institutions and fields. For this purpose, remote training, mentoring, and surgery will be indispensable.