Robotic surgery opens up new avenues for highly advanced gastric cancer

In robotic surgery (RS), it is necessary to understand the functions and features to make the best use of their capabilities. We introduced RS for gastric cancer from April 2018, and all cases have been accepted as indications for RS. The number of cases was 302 by December 2021. 96 cases in highly advanced gastric cancer (T4a-T4b or N3a-N3b) have been performed RS, and distal gastrectomy (RDG) was performed in 65 cases. Operative time was 288 (150-592) min, a difference of around 30 min compared to LDG. The blood loss was 80 (7-499) ml, it was 30ml less than that of LDG. Postoperative hospital stay was 11 (8-32) days in RDG and 14 (9-21) days in LDG, with a trend toward shorter in RDG. In our department, Maryland bipolar and Vessel Sealer Extend has been used for the third arm. This maneuver can be adapted to all cases. It is important that the concepts of incision, dissection and dissection are fully understood and reflected in the RS. As RS has no tactile sensation, the key factor is how to link the visual information to the technique. RS is likely to be useful for highly advanced gastric cancer by making the most of its capabilities.