Short‐Term Outcomes of a Novel Hybrid Technique, Minimally Invasive Laparoscopic and Robotic Surgery ( MILAR ) Using the da Vinci SP System for Gastric Cancer

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Abstract
Background: Robotic surgery may have shown advantages over conventional laparoscopic surgery, but the da Vinci SP system, which utilizes a single incision, has had limited use in gastric cancer surgery. This study aims to evaluate the short‐term outcomes of a novel hybrid technique, minimally invasive laparoscopic and robotic surgery (MILAR), with the da Vinci SP system for gastric cancer. Materials and Methods: This retrospective study reviewed 23 consecutive patients who underwent gastrectomy for gastric cancer using the MILAR technique with the da Vinci SP system between May and October 2024. Operative time, blood loss, and morbidity were analyzed. Results: The median operation time was 192 min (191 min for distal gastrectomy, 174 min for proximal gastrectomy, and 308 min for total gastrectomy). Blood loss was minimal, with a median of 13 mL and no patient exceeding 250 mL. Postoperative complications were also minimal; one patient developed a grade II intra‐abdominal fluid infection and another had grade II enteritis. There were no anastomotic leakages or pancreatic fistulas, and no grade III or higher complications were observed. Conclusions: MILAR using the da Vinci SP system is feasible and safe for gastric cancer surgery, with minimal blood loss and acceptable operative times. This is the first report from Japan showing the successful application of this system in gastric cancer, offering new prospects in minimally invasive surgery.

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