Vol.:(0123456789) 1 3 Updates in Surgery https://doi.org/10.1007/s13304-018-0533-5 ORIGINAL ARTICLE Robotic assisted gastrectomy compared with open resection: a case‑matched study Riccardo Caruso 1  · Emilio Vicente 1  · Yolanda Quijano 1  · Benedetto Ielpo 1  · Hipolito Duran 1  · Eduardo Diaz 1  · Isabel Fabra 1  · Valentina Ferri 1 Received: 4 December 2017 / Accepted: 26 April 2018 © Italian Society of Surgery (SIC) 2018 Abstract In recent years, increasingly sophisticated tools have allowed for more complex robotic surgery. Robotic gastrectomy, however, is adopted in only a few selected centers. The goals of this study were to examine the adoption of robotic gastrec- tomy and to compare outcomes between open and robotic gastric resections. This is a case-matched analysis of patients who underwent robotic and open gastric resection performed at Sanchinarro University Hospital, Madrid from November 2011 to February 2017. Patient data were obtained retrospectively. Clinicopathologic characteristics and perioperative and postoperative outcomes were recorded and analyzed. Two groups of demographically similar patients were analyzed: the robotic group (n = 20) and the open surgery group (n = 19). The patient characteristics of the two groups have been com- pared. Robotic resection resulted in less blood loss, shorter postoperative hospital stay, and a longer operating time. The two groups had similar complication rates. Pathological data were similar for both procedures. Robotic gastrectomy for locally advanced gastric carcinoma is safe, and long-term outcomes are comparable to those patients who underwent open resec- tion. Robotic gastrectomy resulted in a shorter hospital stay, less blood loss and morbidity comparable with the outcomes of open gastrectomy. Keywords Robotic gastric cancer · Gastric cancer · Minimally invasive surgery · Reconstruction · Robotic gastrectomy · Total gastrectomy Introduction Total and subtotal gastrectomy with D2 lymph node dis- section is the standard surgical procedure for most resect- able gastric cancers [1]. Today, there are clearly important changes in the surgical approach of gastric cancer treatment due to an increased interest in the minimally invasive sur- gery (MIS) approach, as described by several authors in various felds [2]. MIS has progressively gained widespread interest for its important outcomes compared with the tra- ditional open surgery approach [3, 4]. MIS may ofer many advantages, including reduced postoperative pain, rapid recovery of gastrointestinal function and a shorter hospi- tal stay. Nevertheless, laparoscopy gastrectomy (LG) has several notable limitations, especially the requirement for extensive D2 lymph node dissection which is performed in only a small number of medical centers that have extensive experience in esophagogastric surgery [5]. The robotic sur- gical system (RSS) was developed to overcome the current disadvantages of conventional laparoscopic surgery (LS). The potential advantages of robotic gastrectomy (RG) are related to the wristed instruments, 3D visualization, and improved ergonomics [6, 7]. In this series, we match open and robotic gastric resec- tion. The safety and oncologic outcomes are compared between open and robotic resections. Materials and methods This study is a review of a prospectively collected data- base including patients undergoing robotic and open total gastrectomies for gastric cancer between November 2011 and February 2017. Patient demographics, operative data, * Riccardo Caruso ricaruso2@gmail.com 1 General Surgery Department, Sanchinarro University Hospital, San Pablo University, CEU, C/Oña nº 10, 28050 Madrid, Spain