• Yanghee Woo, Woo Jin Hyung, Kyung-Ho Pak, Kazuki Inaba, Kazutaka Obama, Seung Ho Choi, and Sung Hoon Noh.
• Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
• Arch Surg. 2011 Sep 1;146(9):1086-92.

ObjectiveTo evaluate the comparative safety and efficacy of robotic vs laparoscopic gastrectomy for early-stage gastric cancer.DesignRetrospective analysis.SettingTertiary hospital.PatientsEight hundred twenty-seven patients with gastric cancer.InterventionsBetween July 2005 and April 2009, 827 patients with gastric cancer underwent 236 robotic and 591 laparoscopic radical gastrectomies with curative intent. The patients' data were prospectively collected and retrospectively analyzed.Main Outcome MeasuresWe performed a comparative analysis between the robotic surgery group and laparoscopic surgery group for preoperative patient characteristics, intraoperative factors, and postoperative morbidity and mortality.ResultsThe robotic group was younger than the laparoscopic group, but other preoperative patient characteristics did not differ. The mean operative time for the robotic group (219.5 minutes) was on average 49 minutes longer than the laparoscopic group (170.7 minutes) (P < .001), while mean blood loss was significantly less in the robotic group (91.6 mL vs 147.9 mL; P = .002). The robotic group had mortality of 0.4% and morbidity of 11.0%, comparable with those of the laparoscopic group (P > .05). The number of lymph nodes retrieved per level was adequate in both groups and did not differ significantly. Robotic D1+α (n = 5), D1+β (n = 126), and D2 (n = 105) dissections retrieved 27.2, 36.7, and 42.4 mean numbers of lymph nodes, respectively. Except for 3 cases in the laparoscopic group, all specimens had negative margins.ConclusionsOur largest comparative study demonstrates robotic gastrectomy to have better short-term and comparable oncologic outcomes compared with laparoscopic gastrectomy. A robotic approach to gastric cancer is a promising alternative to laparoscopic surgery.

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