关键词: 胃癌, 远端胃癌根治术, 机器人手术, 手术时间

Abstract: To explore the advantages of the "3-arm + 2-port （3+2）" model over the traditional "4-arm + 1-port （4+1）" model in da Vinci robot-assisted radical distal gastrectomy for gastric cancer. Methods    A retrospective analysis was conducted on 192 patients who underwent da Vinci robot-assisted radical gastrectomy for gastric cancer at Renji Hospital, Shanghai Jiao Tong University School of Medicine from March 1st, 2023, to November 30th, 2024. After propensity score matching （PSM） at a ratio of 1∶2, perioperative variables were compared between the two groups. Results    After PSM, compared to the traditional "4+1" group, the laparoscopic-like "3+2" group showed shorter overall operation time ［（221.1±32.93） min vs. （244.9±27.77） min］, omentectomy time ［（19.5±1.86） min vs. （26.1±3.28） min］, lymph node dissection time for No.11p, 8a, 7, and 9 ［（20.8±2.18） min vs. （22.3±4.01） min］, No.1 and 3 ［（21.1±1.33） min vs. （23.4±5.73） min］, setup time ［（10.5±1.05） min vs. （12.2±1.81） min］, and organ retraction and adjustment time ［（11.5±1.05） min vs. （13.2±1.73） min］. Moreover, the laparoscopic-like "3+2" model group avoided switching between activation and locking of the same-side robotic arms ［（0±0.0） times vs. （161±53.2） times, P<0.001］, and had a higher number of dissected No.4sb lymph nodes ［（5.4±1.31） vs. （4.7±1.46）］, with all differences being statistically significant （P<0.05）.Additionally, the laparoscopic-like "3+2" group had lower consumable costs ［（34956.1±2835.19） CNY vs. （38688.9±1478.61） CNY］, with differences being statistically significant （P<0.05）. Conclusion    The laparoscopic-like "3+2" model for Da Vinci robot-assisted radical distal gastrectomy not only reduces economic costs and improves surgical efficiency but also offers advantages such as shortening the learning curve, reducing surgical difficulty, and facilitating better cooperation among surgeons. 

Key words: Stomach neoplasms, distal gastrectomy, robot-assisted surgery, operative time