Nishi Masaaki, Takasu Chie, Wada Yuma, Tokunaga Takuya, Kashihara Hideya, Ishikawa Daichi, Yoshimoto Toshiaki, Nakasu Chiharu, Shimada Mistuo
Department of Surgery, University of Tokushima Graduate School, Tokushima, Japan.
Surg Laparosc Endosc Percutan Tech. 2025 Jun 1;35(3):e1369. doi: 10.1097/SLE.0000000000001369.
The da Vinci Surgical System (Intuitive Surgical) currently dominates robotic gastrectomy for gastric cancer. The hinotori Surgical Robot System (Medicaroid Corporation) is a newly developed, Japan-made surgical assist robot. This study aimed to introduce the initial experience of robotic gastrectomy using the hinotori and discuss key techniques and challenges.
This single-center retrospective study involved 10 eligible patients who underwent curative robotic distal gastrectomy using the hinotori for primary Stage I to III gastric cancer. Short-term surgical outcomes were evaluated. Lymph node dissection was mainly performed using the conventional double bipolar technique, left-handed double bipolar technique, or laparoscopic coagulation shears from the assist port.
No patients developed intraoperative complications, and all procedures were successfully completed without conversion to open or laparoscopic surgery. All patients achieved R0 resection. The median operation time was 275 minutes (range, 252 to 336 min), and the estimated blood loss was 5 mL (range, 3 to 20 mL). The drain amylase content on postoperative day 1 was 220.5 IU/L (range, 66 to 1207 IU/L). The median number of retrieved lymph nodes was 29.5 (range, 11 to 58). No patients developed postoperative Clavien-Dindo grade ≥IIIa complications, and there was no mortality.
Robotic gastrectomy using the hinotori shows potential benefits for gastric cancer. Further studies are needed to validate these advantages.
达芬奇手术系统（直观外科公司）目前在胃癌机器人胃切除术中占据主导地位。火鸟手术机器人系统（Medicaroid公司）是一种新开发的、日本制造的手术辅助机器人。本研究旨在介绍使用火鸟进行机器人胃切除术的初步经验，并讨论关键技术和挑战。
这项单中心回顾性研究纳入了10例符合条件的患者，他们使用火鸟接受了根治性机器人远端胃切除术，用于治疗I至III期原发性胃癌。评估了短期手术结果。淋巴结清扫主要采用传统双极技术、左手双极技术或通过辅助端口使用腹腔镜凝血剪进行。
无患者发生术中并发症，所有手术均成功完成，未转为开放手术或腹腔镜手术。所有患者均实现R0切除。中位手术时间为275分钟（范围为252至336分钟），估计失血量为5毫升（范围为3至20毫升）。术后第1天引流液淀粉酶含量为220.5 IU/L（范围为66至1207 IU/L）。中位回收淋巴结数为29.5个（范围为11至58个）。无患者发生术后Clavien-Dindo≥IIIa级并发症，且无死亡病例。
使用火鸟进行机器人胃切除术对胃癌显示出潜在益处。需要进一步研究来验证这些优势。
