Pure Robotic Surgery for Intraluminally Growing Gastrointestinal Stromal Tumors around the Esophagogastric junction or Pyloric Ring.

Abstract

BACKGROUND/AIMS: Laparoscopic resection of gastrointestinal stromal tumors has become wide-spread as a minimally invasive surgical method. However, the limitations of laparoscopic surgery for GISTs are well recognized. METHODOLOGY: We developed a local resection by pure robotic surgical procedure to treat intraluminally growing GISTs located in sites that are unsuitable for laparoscopic surgery. Using articulated robotic arms, the GIST is completely excised with a safe margin while employing a unique technique to provide a good operative view and to prevent the intra-abdominal dissemination of the tumor from the cut edge created by robotic excision. The defect created after excision of the tumor is closed using robotic sewing. RESULTS: Four patients were successfully treated with pure robotic surgery without conversion to laparoscopic or open surgery or changing in the method of gastrectomy. CONCLUSIONS: Using robotic surgery, intraluminally growing GISTs located in sites unsuitable for conventional laparoscopic surgery can be treated with minimally invasive procedures.