Search Results (162)

Background: Management of lateral pelvic lymph node (LPLN) metastasis in advanced lower rectal cancer has historically exemplified a fundamental East–West divide. In Japan, the Japanese Society for Cancer of the Colon and Rectum (JSCCR) considers LPLN metastasis a regional manifestation requiring lateral pelvic lymph node dissection (LPLND). In contrast, Western practice has long approached LPLN disease as systemic, prioritizing neoadjuvant chemoradiotherapy (nCRT) followed by total mesorectal excision (TME) without additional lateral clearance. Recent Advances: Evidence generated from the JCOG0212 trial and subsequent multicenter cohorts has firmly demonstrated that LPLND markedly reduces lateral local recurrence, particularly in patients with radiologically enlarged nodes. These findings have contributed to a paradigm shift: the 2025 European Society for Medical Oncology (ESMO) Guidelines now endorse selective LPLND for suspicious nodes following neoadjuvant therapy, indicating an emerging convergence between Eastern surgical philosophy and Western multimodal treatment strategies. Surgical Innovation: Robotic surgery has transformed the technical execution of LPLND. Its stable, high-definition three-dimensional visualization, wristed instruments, and enhanced precision enable meticulous dissection across four anatomically defined planes: the medial plane (uretero-hypogastric fascia), intermediate plane (vesico-hypogastric fascia), lateral plane (pelvic sidewall), and dorsal plane (pelvic floor and lumbosacral trunk/sacral plexus). These features facilitate consistent nerve-sparing surgery, reduce blood loss, and improve postoperative urinary and sexual function compared with conventional laparoscopy or open approaches. Robotic LPLND therefore represents a contemporary synthesis of Eastern surgical precision and Western evidence-based multimodal therapy—offering an integrated pathway toward optimized oncologic control and enhanced functional outcomes. Full article

Background: Partial nephrectomy (PN) is the standard treatment for localized renal tumors where nephron preservation is feasible. The evolution of minimally invasive surgery has progressed from conventional two-dimensional laparoscopy to three-dimensional (3D) laparoscopy and, more recently, to robotic-assisted techniques. Although robotic and laparoscopic PN have been widely compared, evidence focusing on a complete transition from 3D laparoscopy to robot-assisted partial nephrectomy (RAPN) remains scarce. Methods: This retrospective single-surgeon study included 80 consecutive patients treated between 2018 and 2024, encompassing the full transition period from 3D LPN to RAPN. Thirty-six patients underwent 3D laparoscopy and forty-four underwent robotic surgery, excluding the first ten robotic cases representing the learning phase. Propensity score weighting was applied to minimize baseline differences. Results: Tumors treated with RAPN had significantly higher RENAL scores (median 8 vs. 6, p = 0.001), indicating greater complexity, while perioperative outcomes—including hospital stay, operative time, and complication rates—remained comparable. Warm ischemia time was significantly shorter in the RAPN group (17.5 vs. 22 min, p = 0.005), and the TRIFECTA rate was higher though not statistically significant. Conclusions: These results indicate that a complete transition from 3D laparoscopy to robotic partial nephrectomy is safe and feasible, maintaining or improving outcomes even in more complex tumors and broadening the applicability of nephron-sparing surgery. Full article

Background/Objectives: We aimed to evaluate the feasibility and safety of a combined approach to partial nephrectomy, which involves laparoscopic dissection for kidney as well as renal hilum mobilization, followed by robotic assistance for tumor resection and intracorporeal suturing, integrating the technical advantages of both laparoscopic and robotic surgery. Methods: We retrospectively analyzed 99 patients with clinical stage 1 renal tumors who underwent laparoscopic (LPN, n = 31), robot-assisted (RAPN, n = 16), or combined partial nephrectomy (CPN, n = 52) between 2016 and 2024. CPN involved laparoscopic mobilization of the kidney and renal hilum, followed by robotic tumor excision and intracorporeal suturing. Perioperative and postoperative outcomes were compared across groups. Results: Comparative analysis of the demographic characteristics of patients who underwent LPN, RAPN and CPN revealed no significant differences. The mean operative time (OT) was 126.75 ± 25.28 min for CPN, 121.9 ± 9.5 min for LPN (p = 0.014), and 155.5 ± 18.03 min for RAPN (p < 0.001). The median warm ischemia time (WIT) was 20.0 min (10.0–26.0) for CPN, which is comparable to RAPN at 18.5 min (14.0–23.0) (p = 0.158), but it was significantly longer for LPN at 23.0 min (18.0–28.0) (p < 0.001). The estimated blood loss (EBL) was 120.0 mL (50.0–350.0) for CPN, which is similar to RAPN at 110.0 mL (50.0–300.0) (p = 0.158), while it was higher for LPN at 180.0 mL (100.0–250.0) (p < 0.001). No major intraoperative or postoperative complications classified as Clavien–Dindo grade ≥3 were observed in any group. Conclusions: CPN is a feasible and safe approach for clinical stage 1 renal tumors, combining the efficiency of laparoscopy with the precision of robotics. Compared with LPN and RAPN, CPN showed comparable early oncological and functional results and had shorter operative duration and improved perioperative parameters. Full article

Objective: The objective of our study was to assess the oncological safety of uterine manipulators (UMs) in apparent early-stage (FIGO I-II 2009) endometrial cancer treated by minimally invasive surgery (MIS). Methods: Our single-center retrospective study includes patients who underwent endometrial cancer surgery for apparent early-stage disease by either laparoscopy or by robotic or laparoscopic-assisted vaginal hysterectomy from November 2012 to December 2020. Data on UMs, isolated tumor cells (ITCs), cytology, lymphovascular space invasion, free cancer cells in fallopian tubes, stage, histology and grade were collected. Primary and secondary outcomes were cancer recurrence and disease-specific death. Kaplan–Meier curves and multivariate logistic regression were used for statistical analysis. Results: A total of 930 women with early-stage endometrial cancer were included; 789 (84.8%) had hysterectomy with a uterine manipulator and 141 (15.2%) without. A total of 88% had endometrioid histology, 71.6% were grade 1 and 95.7% had stage I disease. A higher risk of recurrence was observed with the Hohl manipulator (HR: 2.83. 95% CI: 1.004–7.98 p = 0.0492) on univariate analysis. On multivariate analysis, neither UM was associated with recurrence. With a mean follow-up of 48 months (range 3–118), no effect was seen on disease-specific death in either Hohl or V-Care (HR: 1.66. 95% CI: 0.48–5.70 and HR:1.29. 95% CI: 0.33–4.98). In high-grade histologies, UMs were strongly associated with recurrence (HR: 12.1. 95% CI: 1.52–96.6 p = 0.019) and disease-specific death (HR: 10.2. 95% CI: 1.12–92.1 p = 0.032). Conclusions: The use of UMs in MIS for endometrial cancer was associated with higher rates of recurrence without affecting disease-specific death, except in high-grade histologies. Full article

Left colon diverticular disease (LCDD) is prevalent in the aging populations of industrialized countries, with many patients requiring surgery. Elective surgery decisions should consider individual health conditions and quality of life. Typically, surgery is recommended six weeks after an acute episode. This scoping review, following PRISMA-ScR guidelines, analyzed the literature on elective LCDD surgery, focusing on inferior mesenteric artery (IMA) ligation, splenic flexure mobilization (SFM), surgical approach, and extent of resection. The databases searched included PubMed, Embase, and Cochrane Library up to May 2025. Twenty studies met the inclusion criteria: 2 randomized trials (RCTs), 6 systematic reviews, 3 prospective studies, and 9 retrospective cohorts. The findings suggest preserving the IMA and selectively omitting SFM may reduce minor complications without compromising safety. Resection should reach the rectosigmoid junction and include only the affected colon segment. Minimally invasive techniques, especially laparoscopic surgery improve outcomes, reduce morbidity, and are more cost-effective than open surgery. Robotic approaches offer new options for complex cases. Surgical strategies must be tailored to disease severity, patient comorbidities, and anatomy. Further prospective studies are needed to refine guidelines and support personalized surgical decisions in LCDD management. Full article

Background/Objectives: Robotic-assisted surgery (RAS) has emerged as a technological advancement in gastrointestinal (GI) procedures, addressing limitations of conventional laparoscopy through enhanced dexterity, three-dimensional visualization, and ergonomic improvements. While its clinical use is expanding, the comparative benefits and cost-effectiveness of RAS across different GI domains remain unclear. Methods: An umbrella review was conducted to evaluate RAS across six GI domains: esophageal, gastric, liver, biliary, pancreatic, and colorectal. A systematic literature search of PubMed was performed in April 2025, yielding 8961 articles. Reviews published in English since 2018 and comparing RAS with laparoscopic or open approaches in human GI surgery were eligible. A total of 250 articles met the inclusion criteria. Data on technical feasibility, clinical outcomes, and cost-effectiveness were extracted. Methodological quality was appraised using the AMSTAR 2 checklist. Results were synthesized narratively. The study was supported by the National Research Foundation of Korea grant, and the protocol was registered in PROSPERO (CRD420251042541). Results: RAS demonstrated domain-specific advantages. Esophageal and gastric surgeries benefited from enhanced precision and lymphadenectomy, while long-term outcomes were comparable to laparoscopy. Robotic liver and biliary surgeries offered technical advantages in complex cases, but evidence was limited. The most significant clinical benefits were observed in pancreatic and colorectal procedures, in which RAS reduced conversion rates and improved short-term outcomes in anatomically challenging scenarios. Cost-effectiveness was generally unfavorable but showed improvement in high-volume centers due to reduced complications and shorter hospital stays. Conclusions: Robotic assistance provides the most consistent clinical benefit in pancreatic and colorectal surgery, especially for complex, high-risk cases. While high procedural costs remain a barrier, selective use of RAS in appropriate settings may yield improved outcomes. These findings support the need for ongoing evaluation of cost-effectiveness and long-term results to guide evidence-based integration of robotics into GI surgery. Full article

Introduction: Robotic splenectomy has emerged as a promising alternative to laparoscopic surgery, offering potential advantages in precision, ergonomics, and individualized surgical planning. In the context of personalized medicine, robotic technology may enable tailoring of surgical strategies to patient-specific anatomy, spleen size, and comorbid hematologic conditions. However, its clinical superiority remains uncertain due to limited and heterogeneous evidence. Methods: We performed a systematic review and meta-analysis following PRISMA guidelines, utilizing PubMed, CINAHL, Web of Science, and EMBASE databases to locate studies on robotic splenectomies in children. This review was prospectively registered in PROSPERO (CRD420251104285). Risk of bias was assessed using the ROBINS-I tool for non-randomized studies. Random-effects models were fitted using restricted maximum likelihood (REML), and confidence intervals were adjusted using either Knapp–Hartung (HKSJ) or modified Knapp–Hartung (mKH) methods when appropriate. 95% prediction intervals were calculated, and the certainty of evidence for each outcome was assessed using the GRADE approach. Results: This review included 272 pediatric patients from 16 studies conducted between 2003 and 2025, of which five were included in the meta-analysis. No statistically significant differences were observed between robotic and laparoscopic splenectomy for operative time, intraoperative blood loss, conversion to open surgery, blood transfusions, or complications. However, the direction of effect estimates consistently favored the robotic approach. A statistically significant reduction in hospitalization days (−0.93 days; 95% CI: −1.61 to −0.24; p = 0.01) was found, though this became marginally significant after HKSJ adjustment (p = 0.06). Intraoperative blood loss showed significance in the primary model (−63.88 mL; 95% CI: −120.38 to −7.38; p = 0.03), but not after mKH correction (p = 0.16). Heterogeneity was substantial-to-extreme for several outcomes and was only partially accounted for by leave-one-out sensitivity analyses. All findings were rated as very low certainty according to the GRADE framework. Conclusions: Robotic-assisted splenectomy in pediatric patients has been reported as technically feasible and performed safely in selected cases. However, the small number of studies, their retrospective design, substantial methodological heterogeneity, and the resulting very low certainty of the evidence according to GRADE preclude any firm conclusions about its comparative safety or efficacy versus laparoscopy. Well-designed prospective studies are needed to clarify its clinical benefits. Full article

Background: Distal pancreatectomy (DP) is a potentially curative procedure for tumors of the pancreatic body and tail. Minimally invasive DP (MIDP), including laparoscopic and robotic techniques, is increasingly being adopted. This study aimed to evaluate the perioperative outcomes of robotic DP (RDP) in comparison with laparoscopic and open approaches using a network meta-analysis and meta-regression. Methods: We systematically searched MEDLINE, EMBASE, Web of Science, and Scopus for studies comparing at least two surgical approaches. Both Bayesian and frequentist network meta-analyses were performed. Results: Sixty-seven studies involving 18,113 patients met the inclusion criteria. Surface under the cumulative ranking (SUCRA) analysis showed that RDP ranked first in 84.6% of measured parameters. Laparoscopic DP (LDP) demonstrated intermediate performance, whereas open DP (ODP) consistently ranked lowest. Operative time was significantly longer for RDP compared with ODP (MD = +25.93 min, 95% CI 7.68–44.18), while LDP and ODP were comparable. RDP significantly reduced 30-day mortality (OR = 0.37, 95% CI 0.16–0.84) and conversion rates compared with LDP (OR = 0.30, 95% CrI 0.22–0.40). Both minimally invasive approaches (RDP and LDP), compared with open surgery, were associated with reduced blood loss (−304 mL and −273 mL), fewer transfusions (OR 0.25 and 0.30), smaller transfused volumes (−1.98 and −1.86 units), shorter ICU stays (−4.0 and −2.3 days), fewer reinterventions (OR 0.45 and 0.56), and shorter hospital stays (−8.8 and −6.9 days), respectively. Conclusions: Although associated with longer operative time, RDP appears safe and may confer significant advantages over both laparoscopic and open surgery, including reduced 30-day mortality, lower conversion rates, and improved perioperative outcomes, particularly when performed in high-volume, well-equipped centers. Full article

Introduction: In minimally invasive, off-clamp partial nephrectomy (ocMIPN), the reconstructive strategy profoundly influences functional outcomes. Traditional nephrometry scores aid preoperative planning but do not directly inform the choice of closure technique. This dual-institutional study aimed primarily to identify preoperative CT-derived parameters predictive of renorrhaphy versus a sutureless approach, and secondarily to compare perioperative and functional outcomes between these techniques. Methods: We retrospectively analyzed 201 consecutive ocMIPN cases performed using a standardized off-clamp technique by two experienced surgical teams across robotic platforms and conventional laparoscopy. Preoperative CT scans were centrally reviewed to quantify morphometric features, including contact surface area (CSA), tumor radius, and Gerota’s fascia thickness. Univariable and multivariable logistic regression models—one restricted to radiologic variables and one expanded with RENAL score terms—were generated to identify independent predictors. Perioperative outcomes, renal functional metrics, and Trifecta rates were compared between cohorts. Results: Among the 201 patients, 101 (50.2%) underwent sutureless reconstruction and 100 (49.8%) renorrhaphy. Cohorts were comparable at baseline except for tumor size (3.1 vs. 3.6 cm; p = 0.04). In multivariable analysis, CSA > 15 cm² (OR 3.93; 95% CI 1.26–12.26; p = 0.02) and tumor radius (OR 1.14 per mm; 95% CI 1.01–1.29; p = 0.04) consistently predicted renorrhaphy, while Gerota’s fascia < 10 mm emerged as significant only in the expanded specification (OR 0.08; 95% CI 0.01–0.70; p = 0.02). Integration with RENAL improved predictive performance (ΔAUC 0.06; NRI 0.14; IDI 0.07), and the final model demonstrated strong discrimination (AUC 0.81) with satisfactory calibration. Perioperative outcomes, postoperative renal function, and Trifecta achievement were similar between groups (all p ≥ 0.21). Conclusions: A concise set of CT-derived morphologic markers—CSA, tumor radius, and perinephric fascia thickness—anticipated reconstructive strategy in ocMIPN and augmented the discriminatory power of RENAL nephrometry. When anatomy was favorable, sutureless repair was not associated with statistically significant differences in perioperative safety or renal function, although the study was not powered for formal equivalence testing. These findings support the integration of radiologic markers into preoperative planning frameworks for nephron-sparing surgery. Full article

Background and Objectives: This study compares laparoscopic and robotic surgical techniques for rectal cancer, focusing on oncologic outcomes, mesocolic excision quality, lymph node yield, and postoperative sexual and urinary function, while also exploring patient satisfaction and recovery trajectories through clinical outcomes and validated questionnaires. Materials and Methods: A retrospective analysis was conducted on 100 patients who underwent rectal cancer surgery between 2017 and 2021 at our tertiary center—53 underwent laparoscopic and 47 robotic surgery. Demographic data, tumor characteristics, and surgical details (procedure type, lymph node yield, morbidity, and mortality) were collected, and postoperative outcomes, including local recurrence, metastasis, need for reoperation, urinary incontinence, and sexual dysfunction, were compared. Functional outcomes were evaluated using the LARS questionnaire, Wexner score, IPSS, IIEF, and FSFI. Results: No significant differences were found in age, BMI, tumor size, or ASA scores between groups. Robotic surgery was associated with shorter hospital stays (p < 0.001), no conversions to open surgery (vs. 28.3% in laparoscopy), and zero cases of positive circumferential margins (vs. 35.8% in laparoscopy; p < 0.001). Lymphatic and perineural invasion rates were similar. Tumor recurrence occurred in four robotic and six laparoscopic cases, and factors significantly associated with recurrence included pathological stage, hospital stay, and adjuvant treatment. Robotic surgery showed improved urinary and sexual function, with lower Wexner, IPSS, and FSFI scores. Conclusions: Robotic surgery is a safe, effective, and patient-friendly alternative to laparoscopy, offering better preservation of continence and sexual function, reduced conversion rates, and shorter hospitalization, and should be considered the preferred approach in appropriately selected rectal cancer patients. Full article

Objective: This retrospective cohort study compares surgical outcomes among patients with endometrial carcinoma (EC) after the implementation of a robotic-assisted (RA) surgical program at a tertiary care center. Methods: A total of 122 EC patients who underwent surgery between March 2022 and February 2025 were included. Patients were divided into two cohorts based on the implementation of RA surgery: Group 1 (March 2022–August 2023) and Group 2 (September 2023–February 2025). Data collected included demographics, surgical approach, operative time, hospital stay, completion of staging procedures, and 30-day postoperative complications. Results: RA laparoscopy was used predominantly in Group 2, replacing conventional laparoscopy (CL). Laparotomy was significantly less frequent in group 2 (11.9% vs. 36.4%; p < 0.001). Among patients with FIGO stage I, all patients underwent minimally invasive surgery (MIS) in Cohort 2 (100% vs. 71.9%; p < 0.001). Median hospital stay was significantly shorter in Group 2 (3 days vs. 4 days; p < 0.001). A 30-day mortality occurred in one patient (n = 1) within the total study cohort (0.82%) and was attributed to pulmonary embolism on postoperative day 14 after RA laparoscopy. Rates of Grade ≥3 postoperative complications were similar (7.3% vs. 7.5%), as were wound complications (5.5% vs. 3%). The use of sentinel lymph node (SLN) mapping increased significantly in Group 2 (91% vs. 54.5%; p < 0.001). Completion staging procedures were significantly reduced in group 2 (9.1% vs. 0%; p = 0.017). Conclusions: The integration of RA laparoscopy significantly reduced laparotomy rates and hospital stays while increasing SLN mapping. These results support the continued adoption of RA laparoscopy to enhance MIS and improve patient outcomes. Full article

Background/Objectives: Textbook outcome (TO) is a composite quality measure in surgery, but few studies have compared TO between robotic pancreaticoduodenectomy (RPD) and laparoscopic pancreaticoduodenectomy (LPD). This study aimed to evaluate and compare TO following RPD and LPD for periampullary neoplasms. Methods: We retrospectively analyzed 322 patients who underwent minimally invasive PD between 2010 and 2023 (RPD, n = 60; LPD, n = 262). LPD was first introduced in 2004, but only cases performed since 2010 were included, while RPD has been performed since 2019. Propensity score matching (1:2) yielded 48 RPD and 96 LPD patients. TO was defined as the absence of pancreatic fistula, bile leak, post-pancreatectomy hemorrhage, severe complications (Clavien-Dindo ≥ III), readmission, and in-hospital or 30-day mortality. Results: In the entire cohort, 240 of 322 patients (74.5%) achieved TO. After matching, TO rates were 64.6% in RPD and 76.9% in LPD (p = 0.656). Perioperative outcomes, including operative time, blood loss, transfusion, hospital stay, and major complications, were comparable, although RPD showed a higher incidence of hemorrhage (p = 0.032). Multivariate analysis identified body mass index < 25 kg/m² as an independent predictor of achieving TO (OR 3.13, p = 0.008). Conclusions: RPD and LPD achieved comparable textbook outcomes in periampullary surgery. Both approaches are feasible when performed by experienced surgeons, but larger studies with long-term follow-up are needed to validate these findings. Full article

Background: Long-term survival in penile cancer is dependent on the presence and extent of lymph node metastases. Historically, inguinal lymph node dissection (ILND) has been performed via an open approach (O-ILND). More recently, minimally invasive surgical alternatives (MIS-ILND) such as video-endoscopic and robot-assisted ILND have emerged. This review aims to compare the (1) perioperative outcomes, (2) complication rates, and (3) oncological efficacy between O-ILND and MIS-ILND. Methods: We conducted a PRISMA-compliant meta-analysis including studies comparing O-ILND versus MIS-ILND for penile cancer. Outcomes were pooled in random-effects meta-analyses. Results: Sixteen articles comprising 1054 patients were analysed. There was an observed trend towards longer operative time for the MIS-ILND approach (mean difference 28 min; 95% CI −2 to 58 min, p = 0.06), particularly with the robotic-assisted technique. Total LN yield (mean 12.3, mean difference 0.3, 95% CI −0.3 to 0.9, p = 0.13), and positive LN (RR 0.98, 95% CI 0.88–1.10, p = 0.75) were similar between groups. MIS-ILND significantly reduced complication rates for both minor (RR: 0.65, 95% CI 0.45–0.94, p = 0.02) and major complications (RR: 0.25, 95% CI 0.12–0.53, p = 0.002). Particularly, there was also lower wound infection rate with MIS-ILND (RR: 0.43, 95% CI 0.22–0.82, p = 0.02), corresponding to a shorter hospital stay of average 4 days (MD −4, 95% CI −6–−2, p = 0.05). Rates of skin/flap necrosis, lymphedema, lymphocele, and drainage time did not differ significantly. Local groin recurrence and overall survival did not differ between approaches. Conclusions: MIS-ILND is associated with fewer perioperative complications and shorter hospitalisation without compromising oncologic outcomes. These findings support its broader adoption, particularly in high-volume centres with appropriate surgical expertise. Full article

Background: Robotic liver resection (RLR) has seen remarkable advancements in recent years, overcoming many limitations of laparoscopic liver resection (LLR). RLR has evolved to include increasingly complex procedures, offering enhanced precision, reduced blood loss, and lower complication rates. Materials and Methods: A total of 150 consecutive RLRs, performed at the Department of General Surgery II and HPB Unit of Santa Chiara Hospital (Trento, Italy), between January 2013 and June 2024 were retrospectively reviewed. Collected data included demographics, disease etiology, operative parameters, oncologic margins, and perioperative outcomes. Results: Indications were malignant disease in 83% of cases while benign disease accounted for 17%. Minor resections accounted for 91%. Cirrhosis was present in 49% of patients (Child–Pugh A 91%; B 9%; mean MELD 9). According to the Iwate difficulty score, resections were low difficulty in 38% of cases, intermediate in 50%, advanced in 7%, expert in 5%. Conversion rate was 12%, mainly for bleeding or adhesions. Mean blood loss was 159 mL (66% <100 mL); Pringle maneuver was used in 3%; drains omitted in 45%; ICG fluorescence used in 81%. Mean operative time was 250 min (console time 184 min). Mean lesion size was 34 mm; R0 margin rate was 82%. Overall mortality was 1.3%; morbidity 24% (Clavien–Dindo ≥ III in 10%). Mean hospital stay was 7 days (median 5; range 2–46). Conclusions: RLR is a safe and effective alternative to laparoscopy, providing comparable or superior perioperative outcomes. Medium-volume centers can achieve high-quality results with RLR. Continued technological advancements will further expand its applications to increasingly complex liver procedures. Full article

Background: Gastric cancer is increasingly being diagnosed at early stages, enabling the application of curative oncological and surgical approaches. With the growing adoption of minimally invasive techniques, robotic surgery is gaining increasing prominence in the operating rooms. As described by Stoyanova et al., the robotic completely intracorporeal jejunal pouch reconstruction after gastrectomy offers potential benefits, including technical feasibility without significant intraoperative challenges or prolonged operative times, as well as long-term advantages such as a reduced incidence of midline incision hernias. Objectives: This retrospective, single-center study is the first to compare the clinical and oncological outcomes after laparoscopic versus robotic completely intracorporeal jejunal pouch reconstruction following gastrectomy. Methods: A total of 27 patients who underwent gastrectomy between 2018 and 2025 were included in the study, and were divided into two groups: 12 patients in the robotic and 15 patients in the laparoscopic group. The study evaluated mean operative time, intraoperative and postoperative complications, length of hospital and ICU stay, and certain oncological outcomes. Results: A main purpose of the robotic method is the avoidance of an unfavourable midline incision due to the completely intracorporeal pouch reconstruction without substantial technical or clinical disadvantages. Conclusions: Further research involving larger patient cohorts and extended follow-up periods is necessary to draw more definitive conclusions about the relative advantages of this surgical technique. Full article