Current status of robot-assisted gastric surgery

Table 1 Summary of reports on robotic surgery for gastric tumors

Ref.	Yr	Country	Study design	Patients	Surgery	Sample
Hashizume et al[26]	2003	Japan	Review		Robot
Anderson et al[27]	2007	USA	Case series	Gastric adenocarcinoma only	Robot	7
Hyung et al[28]	2007	South Korea	Review, Nonrandomized comparative	Gastric adenocarcinoma only	Initial Robot	10
					Initial Lap.	10
					Recent Lap.	10
Patriti et al[29]	2008	Italy	Case series	Gastric adenocarcinoma only	Robot	13
Pugliese et al[30]	2009	Italy	Nonrandomized comparative	Gastric adenocarcinoma only	Robot	9
					Lap.	46
Song et al[31]	2009	South Korea	Nonrandomized comparative	Gastric adenocarcinoma only	Initial Robot	20
					Initial Lap.	20
					Recent Lap.	20
Song et al[32]	2009	South Korea	Case series	Gastric adenocarcinoma only	Robot	100
Hur et al[33]	2010	South Korea	Case series	Gastric adenocarcinoma only	Robot	7
Pugliese et al[34]	2010	Italy	Nonrandomized comparative	Gastric adenocarcinoma only	Robot	16
					Lap.	48
Kim et al[35]	2010	South Korea	Nonrandomized comparative	Gastric adenocarcinoma only	Robot	16
					Lap.	11
					Open	12
Ryu et al[36]	2010	South Korea	Case series	Gastric adenocarcinoma and gastric SMT	Robot	2
					Lap.	19
Buchs et al[37]	2010	Swizerland	Case series	Gastric SMT only	Robot	5

Lap.: Laparoscopy; SMT: Submucosal tumors.

Table 2 Patients’ characteristics and operative outcomes

Ref.	Surgery	Sample	Sex (M:F)	Mean age (yr)	Mean BMI (kg/m2)	Operation time (min)	Blood loss (mL)	Conversion (%)
Anderson et al[27]1	Robot	7	4:3	64 (53-80)	25.8 (19.3-29.3)	420 (390-480)	300 (100-900)	0
Hyung et al[28]	Initial Robot	10	6:4	54 (35-73)	23.4 (20.8-26.7)	253 (200-316)	-	0
	Initial Lap.	10	8:2	55	23.9 (16.9-29.6)	337 (285-450)	-	0
	Recent Lap.	10	7:3	56	23.1 (19.5-26.1)	164 (120-200)	-	0
Patriti et al[29]	Robot	13	1:1	68.4 ± 11.9	26.13 ± 4.73	286.0 ± 32.6	103.0 ± 87.5	-
Pugliese et al[30]	Robot	9	-	-	-	350 ± 71 (240-460)	92 ± 58 (50-200)	-
	Lap.	46	-	-	-	236 ± 20 (145-360)	156 ± 57 (45-250)	-
Song et al[31]	Initial Robot	20	8:12	51.6 ± 12.5	23.4 ± 2.1	230.0 ± 34.9a	94.8 ± 121.5	0
	Initial Lap.	20	14:6	62.5 ± 12.9	23.6 ± 3.6	289.5 ± 59.3	-	0
	Recent Lap.	20	13:7	55.0 ± 5.8	22.4 ± 2.1	134.0 ± 40.0	39.5 ± 27.7	0
Song et al[32]	Robot	100	54:46	55.4 ± 13.0 (25-89)	23.3 ± 2.74 (17.0-30.1)	231.3 ± 43.2 (155-330)	128.2 ± 217.5 (12-1400)	0
Hur et al[33]	Robot	7	4:3	62 (35-72)	-	205 (190-240)	-	-
Pugliese et al[34]	Robot	16	-	-	-	344 ± 62 (240-460)	90 ± 48 (50-200)	12
	Lap.	48	-	-	-	235 ± 23 (145-360)	148 ± 53 (45-250)	6
Kim et al[35]	Robot	16	10:6	53.8 ± 15.6	21.3 ± 3.4a	259.2 ± 38.9a	30.3 ± 15.1a	-
	Lap.	11	10:1	57.9 ± 13.1	25.3 ± 2.5	203.9 ± 36.4	44.7 ± 37.1	-
	Open	12	9:3	56.0 ± 12.4	25.2 ± 1.9	126.7 ± 24.1	78.8 ± 74.1	-

¹Values in parentheses are interquartile range.

^aP < 0.05. Lap.: Laparoscopy; BMI: Body mass index.

Table 3 Postoperative courses

Ref.	Surgery	Sample	Oral feeding (d)	First flatus time (d)	Postoperative hospital stay (d)	Total complication (%)
Anderson et al[27]1	Robot	7	4 (2-8)	-	4 (3-9)	14.3
Hyung et al[28]	Initial Robot	10	4	2.9	6.0 (5-10)	-
	Initial Lap.	10	4.8	3.1	6.9 (5-8)	-
	Recent Lap.	10	4.3	3.3	6 (5-8)	-
Patriti et al[29]	Robot	13	-	-	11.2 ± 4.3	46.2
Pugliese et al[30]	Robot	9	5 ± 1.1	-	11 ± 1 (10-13)	-
	Lap.	46	5 ± 0.8	-	10 ± 2.5 (7-24)	-
Song et al[31]	Initial Robot	20	4 ± 0	3 ± 0.40	5.7 ± 1.0	5
	Initial Lap.	20	4.95 ± 1.47	3 ± 0.40	7.7 ± 3.5	5
	Recent Lap.	20	4.1 ± 0.45	3.25 ± 0.58	6.2 ± 3.1	10
Song et al[32]	Robot	100	4.2 ± 1.2 (3-15)	2.9 ± 0.5 (1-4)	7.8 ± 17.1 (5-175)	14
Pugliese et al[34]	Robot	16	4.8 ± 1.3	-	10 ± 3 (10-13)	12
	Lap.	48	5 ± 0.8	-	10 ± 2.6 (7-24)	14.5
Kim et al[35]	Robot	16	-	3.2 ± 1.1	5.1 ± 0.3a	-
	Lap.	11	-	3.6 ± 0.9	6.5 ± 0.8	-
	Open	12	-	3.4 ± 0.9	6.7 ± 1.4	-

¹Values in parentheses are interquartile range.

^aP < 0.05. Lap.: Laparoscopy.

Table 4 Pathologic outcomes

Ref.	Patients	Surgery	Sample	LN dissection (D1+αorβ/D2)	LN harvested (number)	Stage (Ia/Ib/II)
Anderson et al[27]1	Gastric adenocarcinoma only	Robot	7	-	24 (17-30)	2/2/2
Hyung et al[28]	Gastric adenocarcinoma only	Initial Robot	10	-	34 (16-50)	-
		Initial Lap.	10	-	29.2 (12-54)	-
		Recent Lap.	10	-	37.8 (26-51)	-
Patriti et al[29]	Gastric adenocarcinoma only	Robot	13	-	28.1 ± 8.3	3/3/6
Pugliese et al[30]	Gastric adenocarcinoma only	Robot	9	-	27.5 ± 5 (18-40)	-
		Lap.	46	-	31.5 ± 9.5 (20-45)	-
Song et al[31]	Gastric adenocarcinoma only	Initial Robot	20	16/4	35.3 ± 10.5	19/1/10
		Initial Lap.	20	10/10	31.5 ± 17.1	14/4/2
		Recent Lap.	20	12/8	42.7 ± 14.9	19/0/1
Song et al[32]	Gastric adenocarcinoma only	Robot	100	58/42	36.7 ± 13.3 (11-83)	74/16/4
Hur et al[33]	Gastric adenocarcinoma only	Robot	7	-	-	-
Pugliese et al[34]	Gastric adenocarcinoma only	Robot	16	-	25 ± 4.5 (18-40)	-
		Lap.	48	-	31 ± 8 (20-45)	-
Kim et al[35]	Gastric adenocarcinoma only	Robot	16	2/14	41.1 ± 10.9	-
		Lap.	11	3/8	37.4 ± 10.0	-
		Open	12	0/12	43.3 ± 10.4	-

¹Values in parentheses are interquartile range. ^aP < 0.05. Lap.: Laparoscopy; LN: Lymph node.