{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:12:02Z","timestamp":1790352722231,"version":"4.1.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100012330","name":"Okayama University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100012330","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Obesity complicates lymph node dissection (LND) during gastric cancer surgery, particularly in deep anatomical zones. While robotic gastrectomy (RG) offers ergonomic advantages, its impact on the technically demanding suprapancreatic area in obese patients remains unclear. This study compared LND quality between RG and laparoscopic gastrectomy (LG) in obese patients.We retrospectively analyzed 404 patients who underwent LG (n\u2009=\u2009319) or RG (n\u2009=\u200985) for gastric cancer. Patients were stratified by body mass index (BMI) (non-obese\u2009&lt;\u200925 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    vs. obese\u2009\u2265\u200925 kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ). We assessed retrieved lymph nodes in the suprapancreatic area (stations 7, 8a, 9) and perigastric area (stations 1\u20136). Two-way analysis of variance (ANOVA) assessed the effects of BMI and surgical approach.In the perigastric area, obesity was an independent risk factor for decreased lymph node yields (p\u2009=\u20090.033), with no significant difference between RG and LG (p\u2009=\u20090.50). Conversely, in the suprapancreatic area, the robotic approach was a strong independent factor for increased retrieval (p\u2009&lt;\u20090.001). Pairwise comparisons showed that obesity significantly reduced yields in the LG group (total: p\u2009=\u20090.012; suprapancreatic: p\u2009=\u20090.015), while the RG group maintained consistently high yields regardless of BMI (p\u2009=\u20090.371 and p\u2009=\u20090.857, respectively).The robotic approach was associated with superior, more consistent suprapancreatic LND, whereas obesity negatively affected perigastric retrieval regardless of platform. These findings suggest that robotic articulation may help maintain the quality of suprapancreatic lymphadenectomy in obese patients.\n                  <\/jats:p>","DOI":"10.1007\/s11701-026-03258-z","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:25:30Z","timestamp":1773030330000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of the articulating robotic system on suprapancreatic lymphadenectomy in obese patients with gastric cancer: A comparative study with conventional laparoscopy"],"prefix":"10.1007","volume":"20","author":[{"given":"Hajime","family":"Kashima","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunya","family":"Hanzawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Kakiuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoru","family":"Kikuchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Kuroda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunsuke","family":"Kagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyoshi","family":"Fujiwara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"issue":"2","key":"3258_CR1","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1016\/S2468-1253(19)30332-2","volume":"5","author":"H Katai","year":"2020","unstructured":"Katai H, Mizusawa J, Katayama H et al (2020) Survival outcomes after laparoscopy-assisted distal gastrectomy versus open distal gastrectomy with nodal dissection for clinical stage IA or IB gastric cancer (JCOG0912): a multicentre, non-inferiority, phase 3 randomised controlled trial. 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The requirement for informed consent was waived due to the retrospective nature of the study, and an opt-out option was provided on the institution\u2019s website.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The requirement for informed consent was waived due to the retrospective nature of the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"327"}}