上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2026, Vol. 46 ›› Issue (8): 1007-1014.doi: 10.3969/j.issn.1674-8115.2026.08.002

• 前沿述评 •    

基于临床研究的机器人胃癌手术发展现况与展望

石彦(), 卢长川, 李政焰   

  1. 陆军军医大学第一附属医院（西南医院）普通外科，重庆 400038
  • 收稿日期:2026-01-23 接受日期:2026-04-28 出版日期:2026-08-05 发布日期:2026-08-05
  • 通讯作者: 石 彦，主任医师，教授；电子信箱：shiyanpwk@tmmu.edu.cn。
  • 作者简介:第一联系人：石彦负责拟定写作思路，设计文章框架，指导文章撰写及修改文稿；卢长川负责查阅文献并撰写文稿；李政焰参与文章的修改。所有作者均阅读并同意了最终稿件的提交。
  • 基金资助:
    重庆市技术创新与应用发展专项项目(CSTB2023TIAD-KPX0053-2)

Current status and prospects of robotic gastric cancer surgery based on clinical research

Shi Yan(), Lu Changchuan, Li Zhengyan   

  1. Department of General Surgery, The First Affiliated Hospital (Southwest Hospital) of Army Medical University, Chongqing 400038, China
  • Received:2026-01-23 Accepted:2026-04-28 Online:2026-08-05 Published:2026-08-05
  • Contact: Shi Yan, E-mail: shiyanpwk@tmmu.edu.cn.
  • About author:First author contact:Shi Yan was responsible for formulating the writing approach, designing the article framework, guiding the manuscript composition, and revising the article. Lu Changchuan undertook literature retrieval and manuscript writing. Li Zhengyan participated in the revision of the article. All authors have read the last version of paper and consented to its submission.
  • Supported by:
    Special Project for Technological Innovation and Application Development of Chongqing(CSTB2023TIAD-KPX0053-2)

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摘要：

安全、精准是微创外科持续发展的核心追求。机器人手术凭借高清三维视野、稳定灵活操控、高精度操作等优势，高度契合现代微创外科的发展理念。机器人胃癌手术作为机器人外科的重要分支，历经20余年的临床探索与迭代演进，技术体系日趋成熟，已实现了规模化推广应用。现有临床研究证实，机器人胃癌手术的近期疗效显著优于腹腔镜胃癌手术，可减少术中出血量、降低术后并发症发生率，在复杂区域淋巴结清扫、全腹腔内消化道重建等关键环节优势显著。随着国产手术机器人快速崛起、单孔机器人不断创新以及5G远程机器人手术的蓬勃发展，机器人胃癌手术的临床适用场景得到进一步拓展。但其远期肿瘤学获益尚未形成共识，高质量前瞻性循证医学证据相对不足，且存在手术时间较长、治疗成本偏高等问题，一定程度上制约了其在基层的普及。该文整合国内外机器人胃癌手术相关临床研究与前沿成果，系统梳理该术式的技术发展沿革、临床应用现状、现存核心问题及未来发展方向，以期为国内机器人胃癌外科的规范化、高质量开展提供理论参考，推动我国胃癌微创外科向精准化、智能化、普惠化持续升级。

关键词: 胃肿瘤, 机器人手术, 微创外科, 精准治疗, 临床研究

Abstract:

Safety and precision are the core pursuits driving the sustainable development of minimally invasive surgery. With advantages including high-definition three-dimensional visualization, stable and flexible instrument manipulation, and highly precise operations, robotic surgery is highly consistent with the developmental concepts of modern minimally invasive surgery. As an important branch of robotic surgery, robotic gastrectomy has undergone more than two decades of clinical exploration and iterative evolution, with its technical system becoming increasingly mature and achieving large-scale clinical application. Clinical studies have confirmed that robotic gastrectomy yields superior short-term outcomes compared with laparoscopic gastrectomy; it can effectively reduce intraoperative blood loss and the incidence of postoperative complications, and also exhibits prominent advantages in key procedures such as dissection of lymph nodes and totally intracorporeal gastrointestinal reconstruction. The clinical application scenarios of robotic gastrectomy have been further expanded with the rapid development of domestically manufactured surgical robots, continuous innovation of single-port robotic systems and vigorous advancement of 5G-based remote robotic surgery. However, consensus has not yet been reached regarding its long-term oncological benefits, high-quality prospective evidence-based medical evidence remains relatively insufficient, and challenges such as prolonged operative time and high treatment costs have, to some extent, restricted its widespread adoption in primary-level hospitals. This review integrates clinical studies and cutting-edge advances in robotic gastrectomy from domestic and international perspectives, systematically elaborates the technical evolution, current clinical application status, predominant existing challenges, and future development directions of this surgical approach. The study aims to provide a theoretical reference for the standardized and high-quality development of domestic robotic gastric surgery in China and drive the continuous advancement of minimally invasive gastric cancer surgery toward precision, intelligence and affordability.

Key words: gastric neoplasm, robotic surgery, minimally invasive surgery, precision medicine, clinical research

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