Chicago 2009 Video – Advantages of Robotic Surgery for the Treatment of Gastric and Right Colon Neoplasm

F. Badessi

Objective
This study aimed to evaluate the feasibility of using a robotic DaVinci system to the treatment of gastric and right colon resections in patients with neoplasm.

Materials and methods
From March 2009 to September we performed by a robotic DaVinci system 5 right emicolectomies and 4 gastric resections. The patients with right colon neoplasm (3 female and 2 male, mean age of 59,2 years range 30-83) were studied by colonscopy with biopsies, barium enema to achieve the correct side of neoplasm and abdomen TC. We performed a lymphadenectomy along the superior mesenteric vein. All the branches tied at them root from superior mesenteric vein. In all cases we performed a ileal-transverse side to side anastomoses by manual technique. The patients with gastric cancer (3 male and 1 female, mean age of 65,3 years range 54-76) were studied by EGDS with biopsies, barium enema and chest-abdomen TC. All cases were neoplasm of distal gastric and in all cases we performed a Roux an Y reconstruction with D2 lymphadenectomy.

Results
The mean operation time for the patients with right colon neoplasm was 192.5 min (+/ 45,6 min). All procedures were successful and no conversions were required. The mean number of harvested lymph nodes was 45 (range 18-72). The mean postoperative hospital stay was 5.6 days (range 4-7,9). The mean operative time for the patients with gastric neoplasm was 254 (+/- 17,4 min) Mean number of nodes retrieved was 35.1 +/- 5,4 and all resection margins were negative. The mean postoperative hospital stay was 6,3 days (range 5-8,6). There was no surgical mortality or morbidity.

Conclusions
In our initial experience we observed that the advantages of robotic DaVinci system’s are represent to the major facility and preciseness to perform the lymphadenectomy and anastomoses that are considered the more demanding steps of laparoscopic right hemicolectomy and gastric resection.