Gastric cancer constitutes a major health problem. Robotic
surgery has been progressively developed in this field. Although the
feasibility of robotic procedures has been demonstrated, there are
unresolved aspects being debated, including the reproducibility of
intracorporeal in place of extracorporeal anastomosis.
Difficulties of traditional laparoscopy have been described and there
are well-known advantages of robotic systems, but few articles in
literature describe a full robotic execution of the reconstructive phase
while others do not give a thorough explanation how this phase was run.
A new reconstructive approach, not yet described in literature, was
recently adopted at our Center.
Robotic total gastrectomy with D2 lymphadenectomy and a socalled
‘‘double-loop’’ reconstruction method with intracorporeal robotsewn
anastomosis (Parisi’s technique) was performed in all reported
cases.
Preoperative, intraoperative, and postoperative data were collected
and a technical note was documented.
All tumors were located at the upper third of the stomach, and no
conversions or intraoperative complications occurred. Histopathological
analysis showed R0 resection obtained in all specimens. Hospital
stay was regular in all patients and discharge was recommended starting
from the 4th postoperative day. No major postoperative complications
or reoperations occurred.
Reconstruction of the digestive tract after total gastrectomy is one of
the main areas of surgical research in the treatment of gastric cancer and
in the field of minimally invasive surgery.
The double-loop method is a valid simplification of the traditional
technique of construction of the Roux-limb that could increase the
feasibility and safety in performing a full hand-sewn intracorporeal
reconstruction and it appears to fit the characteristics of the robotic
system thus obtaining excellent postoperative clinical outcome
