Comparison of short term results following robotic and laparoscopic total gastrectomy and D2 lymph node dissection

Introduction : In the last decade, there has been a progressive shift from open to mini-invasive operative techniques for surgical resection of gastric cancer. Advanced equipment of surgical robots, with its 3D visualization, steady camera view, flexible instrument tips, attracts more and more practitioners in performing robotic gastrectomy with D2 dissection in gastric cancer patients. Thus, the comparison of some basic oncological as well as some surgical variables related to laparoscopic and robotic gastrectomy and D2 lymphadenectomy is necessary. Aim : The aim of the study was to compare our initial short-term results after robotic and laparoscopic gastrectomy. Materials and methods : A retrospective cohort study was performed. For a period of four years between January 2018 and August 2022, a total number of 110 patients with total gastrectomy and D2 lymphadenectomy due to gastric cancer operated in Department of General Surgery, Kaspela University Hospital, Plovdiv, were included into the study. They were separated in two groups: thirty-eight patients with robotic surgery and 72 with laparoscopic assisted procedure. Results : The oncological variables such as location of tumor, nodal status, number of lymph nodes removed, and pathological tumor showed no statistically significant differences between robotic and laparoscopic group. The demographic variables as age, sex, BMI, as well as ASA score also demonstrated no remarkable difference in both groups ( p >0.05). The overall complication rate were similar ( p =0.983). Conclusion : We found no significant advantages of robotic over laparoscopic gastric surgery in our patients. However, we think that robotic surgery is effective, safe, and promising approach to the treatment of gastric cancer capable of correcting some of the disadvantages of laparoscopy.