Journal of Gastric Surgery
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Prospective, observational, multicenter study on minimally invasive gastrectomy for gastric cancer: robotic, laparoscopic and open surgery compared on operative and follow-up outcomes - IMIGASTRIC II study protocol: IMIGASTRIC II
Full text linkBackground:Several meta-analyses have tried to defi ne the role of minimally invasive approaches. However, further evidence to get a wider spread of these methods is necessary. Current studies describe minimally invasive surgery as a possible alternative to open surgery but deserving further clarifi cation. However, despite the increasing interest, the difficulty of planning prospective studies of adequate size accounts for the low level of evidence, which is mostly based on retrospective experiences.A multi-institutional prospective study allows the collection of an impressive amount of data to investigate various aspects of minimally invasive procedures with the opportunity of developing several subgroup analyses.A prospective data collection with high methodological quality on minimally invasive and open gastrectomies can clarify the role of diff erent procedures with the aim to develop specifi c guidelines.Methods and analysis:a multi-institutional prospective database will be established including information on surgical, clinical and oncological features of patients treated for gastric cancer with robotic, laparoscopic or open approaches and subsequent follow-up.The study has been shared by the members of the International study group on Minimally Invasive surgery for GASTRIc Cancer (IMIGASTRIC)The database is designed to be an international electronic submission system and a HIPPA protected real time data repository from high volume gastric cancer centers.Ethics:This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevantlaws/regulations.Trial registration number:NCT0275108
Fluorescence image-guided lymphadenectomy using indocyanine green and near infrared technology during robotic gastrectomy: a prospective pilot study: IG-MIG Study
Full text linkBackground:Gastric cancer is a worldwide challenge due to its spread, even epidemic in some areas, and the high mortality rates. Lymphadenectomy is considered the fundamental step during radical gastrectomy. In recent years, some researchers have tried to find a way to improve the surgical identifi cation of the lymphatic drainage routes and lymph node stations. This new surgical frontier is the so called “navigation surgery”. Among the diff erent reported solutions, lately, the indocyanine green (ICG) has drawn attention. It is a fluorescence dye, that can be detected in the near infrared spectral band (NIR).The development of specific fluorescence imaging devices has allowed surgeons to visualize tumors, vascular and lymphatic structures. The Da Vinci Xi robotic system has an integrated imaging technology that has been used in colo-rectal and hepatobiliary surgery. However, up to date, the combined use of fluorescence imaging and robotic technology has not been evaluated during lymphadenectomy in gastric cancer.Methods:General design: to evaluate the role of fluorescence imaging during robotic lymphadenectomy for gastric cancer.Type of study: interventional prospective pilot study.Duration: 18 months.Experimental group: patients undergoing dissection assisted by ICG.Control group: patients undergoing the same surgery without the injection of ICG.Primary outcomes: Fluorescent lymph nodes (FLNs) identification rate, accuracy of the procedure, comparison with the control group on the total number of lymph nodes retrieved.Sample size: 20 patients in the experimental group, 20 patients in the control group.Ethics:This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations.Trial registration number:NCT0393104
Reconstruction methods during laparoscopic gastrectomy
Full text linkGastric surgery is one of the most relevant fi elds of development for minimally invasive technologies. Laparoscopy is now widespread, and several studies have demonstrated its feasibility and safety even in some advanced oncological procedures. Robotic surgery has several intrinsic advantages that theoretically can improve an extensive lymphadenectomy or the reconstruction phase.Much remains to be addressed in this field and further studies are necessary to offer the patient the best possible approach based on his characteristics and the stage of his disease.The present report off ers an overview on robotics and its role in gastric surgery
Robotic surgery for gastric cancer: expert opinion from a western perspective
Full text linkGastric surgery is one of the most relevant felds of development for minimally invasive technologies. Laparoscopy is now widespread, and several studies have demonstrated its feasibility and safety even in some advanced oncological procedures. Robotic surgery has several intrinsic advantages that theoretically can improve an extensive lymphadenectomy or the reconstruction phase.Much remains to be addressed in this field and further studies are necessary to offer the patient the best possible approach based on his characteristics and the stage of his disease.The present report off ers an overview on robotics and its role in gastric surgery