Department of Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
Surg Today. 2023 Feb;53(2):192-197. doi: 10.1007/s00595-022-02553-0. Epub 2022 Jul 16.
Robotic gastrectomy (RG) for gastric cancer (GC) was approved for national medical insurance coverage in April, 2018, since when its use has increased dramatically throughout Japan. However, the safety of RG performed by surgeons who are not Endoscopic Surgical Skill Qualification System (ESSQS)-qualified has yet to be established. We conducted this study to verify the short-term outcomes of the initial series of RG procedures performed by non-ESSQS-qualified surgeons.
Between January, 2020 and December, 2021, 30 patients with clinical Stage I and II GC underwent RG performed by four non-ESSQS-qualified surgeons according to the Japan Society for Endoscopic Surgery guideline. We evaluated, retrospectively, the morbidity rates according to Clavien-Dindo (CD) classification grade II or higher.
Each operating surgeon completed all procedures without any serious intraoperative adverse events. The median operative time, console time, and estimated blood loss were 413 (308-547) min, 361 (264-482) min, and 25.5 (4-167) mL, respectively. No patient required conversion to laparoscopic or open surgery. Three (10%) patients suffered CD grade II complications postoperatively. The median postoperative hospitalization was 11 (8-51) days.
Non-ESSQS-qualified surgeons trained by expert RG surgeons could perform robotic distal gastrectomy safely for initial cases.
2018 年 4 月，机器人胃癌根治术（RG）被纳入国家医疗保险范围，此后在日本得到了广泛应用。然而，对于未经内镜手术技能资格认证系统（ESSQS）认证的外科医生进行 RG 的安全性尚未得到证实。我们进行这项研究旨在验证非 ESSQS 认证外科医生进行的初始系列 RG 手术的短期结果。
2020 年 1 月至 2021 年 12 月，根据日本内镜外科学会指南，4 名非 ESSQS 认证的外科医生对 30 例临床分期 I 期和 II 期胃癌患者进行了 RG。我们回顾性评估了根据 Clavien-Dindo（CD）分级 II 级或更高的发病率。
每位手术医生均顺利完成了所有手术，没有发生任何严重的术中不良事件。中位手术时间、控制台时间和估计出血量分别为 413（308-547）min、361（264-482）min 和 25.5（4-167）mL。没有患者需要转为腹腔镜或开放性手术。术后有 3 名（10%）患者出现 CD 分级 II 级并发症。中位术后住院时间为 11（8-51）天。
由经验丰富的 RG 外科医生培训的非 ESSQS 认证外科医生可以安全地为初始病例进行机器人远端胃切除术。
