Robot-assisted Laparoscopic total gastrectomy

Mario Masrur, MD, Kristtin Patton, MD, Jean Pierre Martucci, MD, Raquel Gonzalez-Heredia, MD, Fernando E Elli, MD, FACS. University of Illinois at Chicago, Chicago, Illinois, USA..

Robot-assisted gastrectomy has been reported as a safe alternative to the conventional laparoscopy or open approach for treating early gastric carcinoma. We present a case of a gastric chronic bleeding lesion that was completely resected through a MIS approach.

Patients and Method
A 68-year-old lady with history of right mastectomy for breast cancer was admitted to hospital complaining of shortness of breath and anemia. A CT scan of abdomen and upper endoscopy was performed with biopsy sampling of a bleeding lesion that failed to show malignancy. Patient was transfused and compensated and the decision was made to perform a MIS approach with a total gastrectomy and lymphadenectomy since the mass was suspicious of malignancy.

In the OR, after intra-operative diagnostic laparoscopic that failed to show peritoneal or liver mets, a robot-assisted radical total gastrectomy was performed with with Roux-en-
Y reconstruction. Potential advantages of this procedure are the radicallity of the resection preserving the benefits of the MIS approach. The final pathology reported adenocarcinoma T3, N2, M0.

In selected cases, a minimally invasive robotic approach may allow safe total gastrectomy and lymph node dissection, respecting the oncological principles.

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