2018年4月，日本批准使用达芬奇手术系统进行胃癌机器人胃切除术(RG)的国家医疗保险报销，自那以后，该手术的数量迅速增加。我们审查并比较了现有的RG和传统的腹腔镜胃切除术(LG)的证据，以确定手术结果的差异。三名独立的审阅者通过独立机构进行了全面的文献搜索，聚焦于以下九个终点：死亡率、发病率、手术时间、估计失血量、术后住院时间、长期肿瘤学结果、生活质量、学习曲线和成本。与LG相比，RG的术中失血量更少，住院时间更短，学习曲线也更短，但两种手术的死亡率相似。相反，它的缺点包括更长的程序时间和更高的成本。虽然发病率和长期结果几乎相当，但RG表现出更高的潜力。目前，RG的结果被认为与LG相当或更好。在日本获得手术机器人的国家健康保险费用报销资格的机构中，符合LG诊断标准的所有胃癌患者可能适用于RG。©2023年。作者在国际胃癌协会和日本胃癌协会的独家许可下。

Robotic gastrectomy (RG) using the da Vinci Surgical System for gastric cancer was approved for national medical insurance coverage in Japan in April 2018, and its number has been rapidly increasing since then.We reviewed and compared current evidence on RG and conventional laparoscopic gastrectomy (LG) to identify the differences in surgical outcomes.Three independent reviewers systematically reviewed the data collected from a comprehensive literature search by an independent organization, focusing on the following nine endpoints: mortality, morbidity, operative time, estimated blood loss volume, length of postoperative hospital stay, long-term oncologic outcome, quality of life, learning curve, and cost.Compared to LG, RG has lower intraoperative blood loss volume, shorter length of hospital stay, and shorter learning curve, but both procedures have similar mortality. Contrarily, its disadvantages include longer procedural time and higher costs. Although the morbidity rate and long-term outcomes are almost comparable, RG showed superior potentials. Currently, the outcomes of RG are considered comparable to or better than LG.RG might be applicable to all gastric cancer patients who fulfill the indication of LG at institutions that meet specific criteria and are approved to claim the National Health Insurance costs for the use of the surgical robot in Japan.© 2023. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.