Surgeons strive hard to break the Da Vinci code

Excerpt

Although performing effective laparoscopic gastrectomy remains a challenge, especially for cancer in the upper part of the stomach and for advanced-stage cancer, it is no longer considered a topic of great interest in terms of novelty. Current new topics on gastric cancer surgery in the Japanese surgical meetings are more or less focused on single-incision laparoscopic surgery (SILS, or reduced-port surgery) [1] and robotic surgery, both of which should be attempted only by surgeons who are armed with significant expertise in laparoscopic surgery. Perhaps these two techniques could be related to each other in that novel robotic devices that would greatly facilitate surgical procedures in the SILS approach may appear in future [2]. However, the current aims of robotic (or Da Vinci) surgery and SILS in gastric cancer surgery are completely different. To the eyes of this narrow-minded editor, SILS can be viewed as a highly demanding procedure with modest, if any, benefit and with potential harm to the patient. Any highly skilled surgeon who can accomplish gastrectomy by the SILS approach will undoubtedly be able to more comfortably perform the same surgery through the “conventional” laparoscopic approach without greater cost or additional risk of disease recurrence. A greater proportion of people, this editor included, would gladly accept accommodating a few more “holes” measuring 5 mm in diameter if he or she could then expect to receive surgery utilizing a well-established and more secure technique. …