The Safety and Anti-Reflex Effect of Robotic Double-Tract Reconstruction After Proximal Gastrectomy for Gastric Cancer

Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70001. doi: 10.1111/ases.70001.

Abstract

Purpose: Double-tract reconstruction (DTR) is one of the major procedures following proximal gastrectomy (PG) with anti-reflex function for the esophagus. Although many studies demonstrated the feasibility of laparoscopic DTR, there is a lack of research on robotic DTR. We aimed to assess the safety and feasibility of robotic DTR following PG.

Methods: Esophagojejunostomy was performed with a robotic stapler under endoscopic observation using the TilePro function of the Davinci Xi surgical system. The gastrojejunostomy procedure slightly differed depending on the size of the remnant stomach. Along with short-term surgical outcomes, long-term outcomes were compared based on the size of the remnant stomach.

Result: Thirty patients underwent robotic DTR. The median value of operative bleeding was 10 mL, although the median operative and reconstruction times were 398 and 119 min, respectively. Anastomotic complications were absent, and reflux esophagitis was not observed endoscopically 1 year after operation. Body weight loss, symptoms, and blood test findings did not differ significantly.

Conclusion: Robotic DTR may be a safe and favorable procedure in terms of the postoperative course and incidence of reflux esophagitis.

MeSH terms

  • Adult
  • Aged
  • Feasibility Studies
  • Female
  • Gastrectomy* / adverse effects
  • Gastrectomy* / methods
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Plastic Surgery Procedures / methods
  • Retrospective Studies
  • Robotic Surgical Procedures*
  • Stomach Neoplasms* / surgery
  • Treatment Outcome