Single-port Robotic Radical Gastrectomy for Gastric Cancer

Official title

Efficacy and Safety Assessment of Single-port Robotic Radical Gastrectomy for Gastric Cancer: a Phase 2a Trial Based on the IDEAL Framework

Overview

This study is a single-center, phase 2a exploratory clinical study based on IDEAL framework. The intraoperative and postoperative complications were analyzed to evaluate the safety, feasibility and clinical efficacy of single-port robot-assisted gastric tumor resection.

Detailed description

The study assessed the intraoperative adverse events (device-related and/or procedure-related), postoperative complications, perioperative recovery outcomes, surgical specimen quality, and pathological indices of Single-port robot-assisted radical gastrectomy for gastric cancer.

Interventions

• Procedure Single-port Robotic Radical Gastrectomy for Gastric Cancer
  Single-port Robotic Radical Gastrectomy for Gastric Cancer

Primary outcome measures

• Intraoperative adverse events and 30-day postoperative complications [Time frame: Intraoperative and postoperative 30 days]
• Conversion rate [Time frame: Intraoperative]

Secondary outcome measures (5)

• Length of incision [Time frame: Intraoperative]
• Intraoperative Blood Loss [Time frame: Intraoperative]
• Operative Time [Time frame: Intraoperative]
• Postoperative Length of Hospital Stay [Time frame: 7 days after surgery]
• Number of Lymph Nodes Harvested [Time frame: 7 days after surgery]

Eligibility criteria

Inclusion criteria

• (1) Age: 18-75 years; (2) Histologically confirmed gastric adenocarcinoma by endoscopic biopsy; (3) Preoperatively staged as either endoscopically unresectable T1, or cT2-4a with or without nodal involvement (N-/+), and no distant metastasis (M0), according to the 7th edition of the AJCC Cancer Staging Manual; (4) Eligible for potentially curative surgical resection; (5) Eastern Cooperative Oncology Group (ECOG) performance status score of 0-1; (6) American Society of Anesthesiologists (ASA) physical status classification of I-III; (7) Provision of written informed consent.

Exclusion criteria

• (1) Pregnant or lactating women; (2) Severe psychiatric disorder; (3) History of prior upper abdominal surgery; (4) Previous gastrectomy, endoscopic submucosal dissection (ESD), or endoscopic mucosal resection (EMR); (5) Preoperative imaging showing regional lymphadenopathy with lymph node(s) larger than 3 cm in diameter; (6) History of another primary malignancy within the past 5 years; (7) Prior neoadjuvant chemotherapy or radiotherapy; (8) History of cerebrovascular or cardiovascular event (e.g., stroke or myocardial infarction) within the past 6 months; (9) Systemic corticosteroid use for more than one month within the past month; (10) Requirement for concomitant surgery for other conditions; (11) Need for emergency surgery due to gastric cancer-related complications (e.g., bleeding, obstruction, or perforation); (12) Participation in another interventional clinical trial previously; (13) Active severe infectious disease; (14) Severe systemic disease.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

China · 2 centers

• Daping Hospital — Chongqing
• Daping Hospital of Army Medical Universty — Chongqing

Publications

• Ito A, Nakauchi M, Fujita M, Umeki Y, Suzuki K, Serizawa A, Akimoto S, Watanabe Y, Tanaka T, Shibasaki S, Inaba K, Uyama I, Suda K. Initial clinical experiences of robotic distal gastrectomy for gastric cancer using the Da Vinci SP system: a single-center retrospective study. Langenbecks Arch Surg. 2025 Mar 29;410(1):110. doi: 10.1007/s00423-025-03685-w. PMID 40156763
• Park SH, Kim YN, Hwang J, Kim KY, Cho M, Kim YM, Hyung WJ, Kim HI. Safety and feasibility of reduced-port robotic distal gastrectomy for gastric cancer: a phase I/II clinical trial using the da Vinci Single Port(SP) robotic system. Sci Rep. 2023 Oct 30;13(1):18578. doi: 10.1038/s41598-023-45655-6. PMID 37903856
• Shang L, Zhang R, Dong K, Xiao K, Zheng C, Shi Y, Liu H, Jing C, Li L. The world's first pure single-port robotic radical total gastrectomy for advanced gastric cancer. Chin Med J (Engl). 2024 Dec 20;137(24):3151-3152. doi: 10.1097/CM9.0000000000003380. Epub 2024 Nov 28. No abstract available. PMID 39604102
• Qiu WW, Huang ZN, Li TY, Zhang L, She JJ, Jia BQ, Qin XG, Ren SY, Yao HL, Liu DN, Liang H, Shi FY, Li P, Li BP, Zhang XS, Liu KJ, Zheng CH, Lin JX, Huang CM, Li P. Comparison of short- and mid-term outcomes of robotic versus laparoscopic gastrectomy in high-risk patients with gastric cancer: a nationwide, multicentre cohort study. Eur J Surg Oncol. 2025 Oct;51(10):110294. doi: 10.1016/j.ejso.2025. PMID 40651456
• Keller DS, Reif de Paula T, Ikner TP, Saidi H, Schoonyoung H, H Marks J. Perioperative outcomes for single-port robotic versus single-incision laparoscopic surgery: a comparative analysis in colorectal cancer surgery. Surg Endosc. 2024 Mar;38(3):1568-1575. doi: 10.1007/s00464-023-10629-2. Epub 2024 Jan 4. PMID 38177611
• Cheng X, Huang C, Jia W, Guo Z, Shi Y, Song Z, Feng H, Huang H, Xu S, Li H, Wang S, Zhang Y, Zhang T, Liu K, Ji X, Zhao R. Clinical status and future prospects of single-incision robotic-assisted surgery: a review. Int J Surg. 2023 Dec 1;109(12):4221-4237. doi: 10.1097/JS9.0000000000000944. PMID 37988410
• Cianchi F, Staderini F, Badii B. Single-incision laparoscopic colorectal surgery for cancer: state of art. World J Gastroenterol. 2014 May 28;20(20):6073-80. doi: 10.3748/wjg.v20.i20.6073. PMID 24876729
• Markar SR, Karthikesalingam A, Di Franco F, Harris AM. Systematic review and meta-analysis of single-incision versus conventional multiport appendicectomy. Br J Surg. 2013 Dec;100(13):1709-18. doi: 10.1002/bjs.9296. PMID 24227355

Identifiers

NCT: NCT07237126 · SPORTS-04

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗