Robot-assisted stomach cancer surgery. Technical aspects

Abstract

Stomach cancer surgery remains one of the most technically challenging areas in abdominal oncology. The frequency of both intra- and postoperative complications is quite high, despite the modern achievements of anesthesiology and the technical support level. Robot-assisted surgical interventions allow to demonstrate all the benefits of minimally invasive technologies for the patient. Additional security is provided by the control of the video system and robotic instruments by one surgeon. The technical features of the robotic complex can be implemented in reducing the frequency of intra- and postoperative complications and improving the quality of surgical intervention, lymphadenectomy, as well as oncological results. The authors present their methodology for conducting surgical interventions in stomach cancer using a robotic surgical complex. Unlike foreign colleagues who use up to seven robotic instruments, the process of performing gastrectomy and subtotal gastrectomy using four robotic instruments has been developed and optimized, which allows to standardize the technique to the extent possible and reduce financial costs. The technique of using indocyanine green with the possibility of visualization in the infrared spectrum of its accumulation in lymph nodes, which are pathways of lymphogenic metastasis, is described. This can improve the accuracy of staging, determine forecast. KEYWORDS: robot-assisted surgery, stomach cancer, oncology, gastric resection, gastrectomy. FOR CITATION: Kovalenko S.A., Gladyshev D.V., Moiseev M.E. et al. Robot-assisted stomach cancer surgery. Technical aspects. Russian Medical Inquiry. 2023;7(4):218–224 (in Russ.). DOI: 10.32364/2587-6821-2023-7-4-218-224.