New minimally invasive surgery by da Vinci SP (single port) for gastric cancer, “MILLAR”
Takaki Yoshikawa
Oncological curability, preserving function, and minimal invasiveness are keys in surgery for gastric cancer. Curability of open and laparoscopic approach has been shown to be equivalent in many clinical trials. Quality of life after surgery is better by preserving stomach function as much as possible if curability is secured. To avoid reflux after proximal gastrectomy for upper gastric cancer, we selected modified SOFY reconstruction and reported good outcome. Less invasiveness could be measured by incision, blood loss, morbidity, and operation time. Laparoscopic approach has advantages of small incision and less blood loss as compared with open approach. Laparoscopic approach had two types; one is conventional laparoscopic surgery in which surgeons directly treat the scope and the forceps and the other one is robot assisted laparoscopic surgery in which surgeons operate robotic arm connecting to the scope and the forceps. Robotic surgery is expected to have less morbidity. However, conventional laparoscopic or robotic surgery requires longer operation time than open surgery. Recently, a new robot, da Vinci SP (single port) was launched. Da Vinci SP has only one arm in which the scope and three forceps are inserted. We developed MILLAR (minimally invasive surgery using laparoscopy and a da Vinci SP robot) in which we use simultaneously laparoscopic forceps and da Vinci SP, and reported a good outcome of less incision and short operation time.
