Department of Surgery, Fujita Health University, Toyoake, Japan.
Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
Surg Endosc. 2024 Mar;38(3):1626-1636. doi: 10.1007/s00464-024-10695-0. Epub 2024 Feb 8.
Although the da Vinci™ Surgical System is the most predominantly used surgical robot worldwide, other surgical robots are being developed. The Japanese surgical robot hinotori™ Surgical Robot System was launched and approved for clinical use in Japan in November 2022. We performed the first robotic gastrectomy for gastric cancer using hinotori in the world. Here, we report our initial experience and evaluation of the feasibility and safety of robotic gastrectomy for gastric cancer using hinotori.
A single-institution retrospective study was conducted. Between November 2022 and October 2023, 24 patients with gastric cancer underwent robotic gastrectomy with hinotori. Five ports, including one for an assistant, were placed in the upper abdomen, and gastric resection with standard lymphadenectomy and intracorporeal reconstruction were performed. The primary endpoint was the postoperative complication rate within 30 days after surgery. The secondary outcomes were surgical outcomes, including intraoperative adverse events, operative time, blood loss, and the number of dissected nodes.
Of the 24 patients, 16 (66.7%) were male. The median age and body mass index were 73.5 years and 22.9 kg/m, respectively. Twenty-three patients (95.8%) had tumors in the middle to lower stomach. Sixteen (66.7%) and seven (29.2%) patients had clinical stage I and II diseases, respectively. Twenty-three (95.8%) patients underwent distal gastrectomy. No patient had postoperative complications of Clavien-Dindo classification IIIa or higher, whereas two (8.3%) had the grade II complications (enteritis and pneumonia). No intraoperative adverse events, including conversion to other approaches, were observed. All patients received R0 resection. The median operative and console times were 400 and 305 min, respectively. The median blood loss was 14.5 mL, and the number of lymph nodes dissected was 51.5.
This study found that robotic gastrectomy with standard lymphadenectomy for gastric cancer using hinotori can be safely performed.
尽管达芬奇手术机器人是全球应用最广泛的手术机器人，但其他手术机器人也在不断研发中。日本手术机器人 hinotori 手术机器人系统于 2022 年 11 月在日本推出并获得临床使用批准。我们在世界上首次使用 hinotori 进行了机器人胃癌根治术。在此，我们报告我们使用 hinotori 进行机器人胃癌根治术的初步经验和对其可行性和安全性的评估。
这是一项单中心回顾性研究。2022 年 11 月至 2023 年 10 月，24 例胃癌患者接受了 hinotori 机器人辅助胃切除术。在上腹部放置了 5 个端口，包括一个助手端口，并进行了标准的淋巴结清扫和腔内重建。主要终点是术后 30 天内的并发症发生率。次要结果是手术结果，包括术中不良事件、手术时间、出血量和淋巴结清扫数量。
24 例患者中，男性 16 例（66.7%），中位年龄和体重指数分别为 73.5 岁和 22.9kg/m。23 例（95.8%）患者肿瘤位于中下段胃。16 例（66.7%）和 7 例（29.2%）患者分别为临床 I 期和 II 期疾病。23 例（95.8%）患者行远端胃切除术。无患者发生 Clavien-Dindo 分级 IIIa 或更高的术后并发症，2 例（8.3%）发生 II 级并发症（肠炎和肺炎）。无术中不良事件，包括转为其他方法。所有患者均行 R0 切除。手术和控制台时间的中位数分别为 400 分钟和 305 分钟。中位出血量为 14.5mL，淋巴结清扫数为 51.5 个。
本研究发现，使用 hinotori 进行标准淋巴结清扫的机器人胃癌根治术是安全可行的。
