Current Status and Future Applications of Robotic Surgery in Upper Gastrointestinal Surgery: A Narrative Review.

Robot-assisted surgery has proven highly effective in the curative treatment of various gastrointestinal cancers. The advantages of robot-assisted surgery, including precision, enhanced operability, and magnified 3D visualization, allow surgeons to perform delicate procedures that would be challenging with conventional laparotomy or laparoscopy. These benefits make robot-assisted surgery a viable modality for treating various malignant tumors and an essential tool in curative surgery for solid cancers. Laparoscopic gastrectomy is currently the standard treatment for early gastric cancer, with numerous clinical trials assessing the efficacy of robot-assisted surgery. Although thoracoscopic esophagectomy has demonstrated advantages over open surgery in radical esophageal cancer treatment, ongoing studies are evaluating the noninferiority and potential benefits of robotic surgery. Robot-assisted surgery is also being explored for conversion surgery in cases where radical resection becomes feasible after multidisciplinary treatment and in polysurgery cases involving multiple prior laparotomies. However, establishing robust evidence for its efficacy in radical surgery for conversion and polysurgery cases remains a challenge. This narrative review discusses the advantages and limitations of robot-assisted surgery in such complex cases based on an analysis of the literature. Additionally, it examines the prospects of robotic-assisted surgery in polysurgery, metachronous remnant gastric cancer, and conversion surgery.