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Laparoscopic and Robotic Surgery for Gastrointestinal and Hepato-Pancreato-Biliary Cancers

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Dear Colleagues,

We invite you to contribute to the Special Issue of Cancers, titled “Laparoscopic and Robotic Surgery for Gastrointestinal and Hepato-Pancreato-Biliary Cancers”. Laparoscopic and robotic techniques offer minimally invasive options for treating gastrointestinal and hepato-pancreato-biliary cancers, providing potential benefits such as faster recovery and improved short-term outcomes.

Despite advances in multidisciplinary treatments, surgery remains the only potentially curative approach for these malignancies. Minimally invasive surgery—including laparoscopic and robotic methods—has become increasingly mainstream in gastrointestinal and hepato-pancreato-biliary procedures. While such approaches have demonstrated safety and feasibility their long-term oncological outcomes remain under debate, highlighting the need for further research.

This Special Issue aims to explore current surgical management strategies for gastrointestinal and hepato-pancreato-biliary cancers, with a focus on minimally invasive surgery, neoadjuvant and adjuvant therapies, and clinical outcomes. We also welcome submissions presenting translational research related to this topic.

We look forward to receiving your submissions.

Dr. Kosei Takagi
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

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18 pages, 1041 KB

Open AccessArticle

Robotic Gastrectomy and Delivery of Adjuvant Systemic Therapy in Locally Advanced Gastric Adenocarcinoma: An NCDB Propensity Score-Matched Analysis

by Joseph Broderick, Jun Okui, Paul Mansfield, Hop S. Tran Cao, Brian D. Badgwell and Naruhiko Ikoma

Cancers 2026, 18(7), 1073; https://doi.org/10.3390/cancers18071073 - 26 Mar 2026

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Abstract

Background/Objectives: Completion of perioperative systemic therapy is essential for improving survival in patients with locally advanced gastric adenocarcinoma; however, many patients do not receive planned adjuvant therapy because of surgical complications or inadequate recovery. Robotic gastrectomy may improve postoperative recovery and facilitate adjuvant therapy delivery, but contemporary national data remain limited. This study evaluated the association between surgical approach and adjuvant systemic therapy utilization. Methods: Adults with non-metastatic, locally advanced (>pT2N0 or received neoadjuvant chemotherapy) gastric adenocarcinoma who underwent gastrectomy from 2016 to 2021 were identified from the National Cancer Database. Patients who met the criteria for adjuvant systemic therapy were included. Propensity score matching was performed to compare robotic gastrectomy (RG) with laparoscopic gastrectomy (LG) and open gastrectomy (OG). The primary outcome was receipt of adjuvant systemic therapy (ASTx). The secondary outcomes included days from surgery to ASTx initiation, perioperative outcomes, oncologic quality metrics, and overall survival. Results: Among 5853 eligible patients, 17.8% underwent RG. After propensity score matching, ASTx utilization was similar between RG and LG (43.6% vs. 43.9%, p = 0.946) and between RG and OG (44.5% vs. 48.0%, p = 0.144), with no differences in days from surgery to ASTx initiation. Compared with LG, RG was associated with higher R0 resection rates but higher unplanned 30-day readmission rates. Compared with OG, RG was associated with higher R0 resection rates, greater regional lymph node examination, shorter length of stay, and lower 90-day mortality rates. Overall survival rates did not significantly differ between approaches. Conclusions: In this contemporary national analysis, RG did not result in improved delivery or timing of adjuvant systemic therapy despite favorable perioperative outcomes. These findings suggest that considering surgical approach alone is insufficient to address barriers to completion of multimodality therapy in gastric cancer. Full article

(This article belongs to the Special Issue Laparoscopic and Robotic Surgery for Gastrointestinal and Hepato-Pancreato-Biliary Cancers)

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11 pages, 353 KB

Open AccessArticle

Outcomes After Robot-Assisted Versus Open Pancreatoduodenectomy: A Propensity Score-Matching Analysis in a High-Volume Center (TAKUMI-7)

by Kosei Takagi, Tomokazu Fuji, Kazuya Yasui, Yuzo Umeda, Ryuichi Yoshida, Motohiko Yamada, Takeyoshi Nishiyama, Yasuo Nagai, Atene Ito, Naohiro Okada, Shohei Yokoyama and Toshiyoshi Fujiwara

Cancers 2026, 18(4), 602; https://doi.org/10.3390/cancers18040602 - 12 Feb 2026

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Abstract

Background/Objectives: Although the safety and feasibility of robot-assisted pancreatoduodenectomy (RPD) compared to open pancreatoduodenectomy (OPD) have been reported, studies investigating the advantages of RPD remain limited. Moreover, only a few studies have investigated the effects of robotic surgery on textbook outcomes (TO). Methods: This single-center retrospective study included 400 patients who underwent RPD and OPD at our institution between January 2017 and December 2025. Outcomes were compared between the RPD (n = 162) and OPD (n = 238) groups using propensity score-matching (PSM) analysis. The factors associated with TO were examined. Results: Before PSM, significant differences were observed between the groups. PSM yielded RPD (n = 117) and OPD (n = 117) with equal preoperative factors. The RPD group demonstrated a significantly shorter operative time (402 vs. 444 min, p < 0.001), lesser blood loss (75 vs. 270 mL, p < 0.001), shorter postoperative hospital stays (13 vs. 22 days, p < 0.001), and fewer major complications (17.1 vs. 44.4%, p < 0.001), resulting in a higher TO achievement rate (76.9 vs. 52.1%, p = 0.001). Adjusted multivariate analyses identified robotic surgery (odds ratio 3.04, p < 0.001) as an independent predictor of TO. Conclusions: This study demonstrated that RPD was potentially superior to OPD in terms of short-term outcomes. Robotic surgery was significantly associated with TO after pancreatoduodenectomy at the expert’s hand. Full article

(This article belongs to the Special Issue Laparoscopic and Robotic Surgery for Gastrointestinal and Hepato-Pancreato-Biliary Cancers)

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