La Jornada: Robot-assisted gastric cancer surgery offers clinical advantages over laparoscopy

Madrid. A new study from Fujita Health University (Japan), published in the journal Gastric Cancerdemonstrated that robot-assisted surgery shows clinical advantages over laparoscopy in patients with gastric cancer.

Surgery remains the main curative-intent treatment for gastric cancer, and laparoscopic gastrectomy (LG) has established itself as a standard minimally invasive approach. Although GL allows for a faster recovery than open surgery, it is still technically demanding, as surgeons must operate in a confined space using rigid instruments that can amplify hand tremors.

Robotic gastrectomy (RG) was developed to overcome these limitations by providing greater precision, more dexterity, and better visualization. Although GR has become increasingly widespread, until now it was unclear whether it offered relevant clinical benefits over conventional laparoscopic surgery in routine practice.

In Japan, GR was included in national insurance coverage in 2018, followed by regulatory changes that expanded access to robotic surgery and increased the number of experts trained to perform this procedure. Five years later, researchers set out to determine whether these advances had translated into better outcomes for patients undergoing surgery for gastric cancer.

To answer this question, the researchers analyzed reports from the National Clinical Database of Japan and identified patients who underwent distal (GD) or total gastrectomy (GT) using minimally invasive techniques between January 2023 and December 2024. Using propensity score matching, which allowed for differences between patients, they compared 9,743 pairs of people who underwent robotic and laparoscopic GD, as well as 1,000 617 underwent robotic and laparoscopic GT.

“GR has been widely integrated into routine clinical practice throughout Japan. Under current conditions, it remains critical to determine whether GR offers tangible clinical advantages over GL,” said Professor Susumu Shibasaki of Fujita Health University.

The analysis showed that robotic procedures consistently required more surgical time than laparoscopic surgery,