Seoul St. Mary's Hospital Achieves First Success in Single-Port Robotic Surgery for Gastric Tumor Patients

Professor Seo Hoseok of Gastrointestinal Surgery Performs Gastric Tumor Resection on Two Patients
"Minimizing Stomach Resection with Small Incisions, Maximizing Stomach Function Preservation"

Professor Seo Hoseok, Department of Gastrointestinal Surgery, Seoul St. Mary's Hospital.

[Asia Economy Reporter Lee Gwan-joo] Professor Seo Ho-seok of the Department of Gastrointestinal Surgery at Catholic University Seoul St. Mary's Hospital announced on the 7th that he successfully performed surgery on two patients with gastric tumors using a new treatment method called 'single-port robotic surgery,' which combines the advantages of laparoscopic single-port surgery and robotic surgery. While early gastric cancer surgery using single-port robotics has been reported, this is the first case of gastric tumor resection.

The two patients were middle-aged women in whom gastric subepithelial tumors were discovered during routine gastroscopy health screenings. Gastric subepithelial tumors are various types of tumors that arise beneath the gastric mucosa; unlike gastric cancer, the mucosa remains intact while a bulging mass forms underneath. These tumors are found in 1 to 2 out of every 100 people undergoing gastroscopy.

Gastrointestinal stromal tumors (GIST), leiomyomas, and neurogenic tumors are examples of gastric subepithelial tumors. Among these, GISTs require removal because if left untreated, they can increase in size, invade other organs, or metastasize. If pathology results indicate high malignancy, chemotherapy is necessary. Therefore, subepithelial tumors smaller than 2 cm are usually monitored, but those larger than 2 cm require removal.

The tumors in the two patients were located at the gastroesophageal junction, the lesser curvature (the short side of the stomach), and the posterior wall, making access to these locations difficult for removal. Additionally, depending on the changes in stomach shape after resection, preserving function was challenging. Since about half of the stomach might need to be resected, very delicate and precise surgery was required to preserve stomach function.

Professor Seo utilized the 4th generation Da Vinci single-port (SP) robot, combining the benefits of single-port laparoscopy that minimizes scars and wounds with an expanded 3D, high-definition wide field of view and free instrument movement to access narrow and deep surgical sites and perform precise surgery. Both the surgical instruments and camera mounted on the robotic arms have two joints, allowing for multi-angle high-definition views, which aids in removing tumors in difficult locations. Stable and meticulous surgery is possible in narrow and confined spaces, resulting in less postoperative pain and faster recovery for patients.

Professor Seo stated, “While single-port robotic surgery is expanding recently in hernia, rectal cancer, prostate cancer, breast cancer, and gynecological surgeries, it is significant that benign gastric tumors located in difficult-to-resect areas were removed using single-port robotics, leaving minimal scars and preserving stomach function as much as possible.” He added, “Since robotic gastrectomy is not yet covered by health insurance and is expensive, tumors in easily resectable locations are better treated with conventional surgery. However, for tumors in difficult locations, robotic surgery is useful for minimal resection and maximal preservation of stomach function.”

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