Ultrasound-guided, organ-sparing, robotic resection of gastrointestinal stromal tumors of the stomach.

BACKGROUND

Growing data support the use of minimally invasive, organ-sparing resection for gastric gastrointestinal stromal tumors (GISTs), primarily due to reduced postoperative morbidity and faster recovery. In recent years, evidence has suggested the potential benefits of robotics over pure laparoscopic techniques in terms of conversion to open surgery and reduced recourse to mechanical staplers. This study reports our experience with a fully robotic, ultrasound-guided, organ-sparing, nonmechanical resections of gastric GISTs.

METHODS

All consecutive patients with gastric GISTs who underwent robotic excision over a 10-year period by a single surgical team were included in this analysis. The perioperative and clinicopathological outcomes were assessed.

RESULTS

A total of 46 consecutive patients with gastric GIST were included in the study. Of note, 63% of cases involved lesions located in challenging locations, including the antropyloric region, in proximity to the esophagogastric junction, or on the posterior wall. All patients underwent successful organ-sparing procedures, with a mean operative time of 153 ± 65 minutes. No intraoperative complications were observed, and no conversions to open surgery occurred. The rate of postoperative morbidity was <5%. The patients had a mean length of postoperative hospital stay of 4 days. There were no cases of intraoperative tumor spillage. All patients achieved R0 resection, with a mean tumor size of 4.5 ± 3.3 cm. At a median follow-up of 36 months, the disease-free survival rate was 98%.

CONCLUSION

Our findings support the safety and oncological efficacy of robotic gastric GIST resection using an ultrasound-guided, organ-preserving approach. This technique is particularly effective in minimizing organ sacrifice in anatomically challenging locations, demonstrating a high rate of technical success and minimal postoperative morbidity.