Robotic surgery for gastroenterological malignancies

In Japan, the usefulness of robot-assisted surgery using da Vinci surgical system (DVSS) has rapidly become widely acknowledged. At Fujita Health University, DVSS was introduced in 2009. Thus far, 347 patients were treated by DVSS at our institute, including 204 gastroenterological operations. In our department, robot-assisted gastrectomy (RAG, n=111) and robot-assisted esophagectomy (REG, n=26) have been technically standardized. Recently, we reported that both RAG and REG are minimally invasive. Moreover, we showed that the incidence of recurrent nerve palsy by lymphadenectomy was significantly reduced by REG, compared with conventional thoracoscopic esophagectomy. Although robot-assisted surgery is a highly expensive treatment, these results prompt the need for further evaluation of the effectiveness of robot-assisted surgery in the gastroenterological field. Development of a more accurate and less invasive robotic surgery system would contribute to a better quality of life patients with gastroenterological malignancies.