Robotic subtotal D2-gastrectomy for gastric cancer after right hemiliver transplantation: case report and literature review

Acta Chir Belg. 2024 Sep 25:1-7. doi: 10.1080/00015458.2024.2406603. Online ahead of print.

Abstract

Background: With the progress achieved in transplant surgeries an improved long-term survival of patients is obtained due to more effective immunosuppressant therapy. De novo malignancy (DNM) has gained interest in this group of patients. DNM is a major cause of late mortality after liver transplantation.

Methods: We report the case of a patient who underwent orthotopic liver transplantation with right hemiliver (right split) 18 years ago who came to our attention for gastric cancer. We performed a robotic subtotal gastrectomy D2 lymphadenectomy with manual latero lateral trans mesocolic BII gastro jejunal anastomosis using da Vinci robotic surgery system at our hospital.

Results: The operation was successful, the operative time was 230 min, the intraoperative blood loss was 100 ml. The patient was discharged on day 8 after surgery, and no complications occurred. Postoperative pathological stages were pT2 N0 (0/25). During the follow-up period, the patient was in good health without long-term complications.

Conclusion: Robotic approach is feasible in patients after liver transplantation.

Keywords: Da Vinci robot surgery system; case report; gastrectomy; gastric cancer (GC); liver transplantation.