{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T14:38:36Z","timestamp":1794062316005,"version":"4.8.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T00:00:00Z","timestamp":1789171200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"International University of Health and Welfare"}],"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                    Spleen-preserving dissection of the No. 10 (splenic hilar) nodal station is technically demanding, given the narrow working space bordered by terminal splenic vessels and the pancreatic tail. This study aimed to compare short-term outcomes of robotic and laparoscopic No. 10 dissection. We retrospectively compared 113 patients undergoing gastrectomy with No. 10 dissection (laparoscopic,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200969; robotic,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200944) at a single center (November 2008\u2013March 2026). Propensity scores (age, sex, BMI, preoperative chemotherapy, clinical T4 status, nodal positivity) were used for 1:1 nearest-neighbor matching (0.2-SD logit caliper), yielding 35 pairs; paired outcomes were compared with Wilcoxon signed-rank and McNemar tests. In the matched cohort, robotic surgery had less blood loss (0 [IQR 0\u201320] vs. 30 [5\u2013150] mL;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001), lower day-1 drain amylase (248 [161\u2013481] vs. 593 [427\u20131113] IU\/L;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.001), and higher No. 10 nodal yield (1 [1\u20132] vs. 1 [1\u20131];\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.009), with a trend toward longer operative time (404 [367\u2013438] vs. 372 [333\u2013402] min;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.050). Total nodal yield, morbidity (overall 17.1% vs. 11.4%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.683; severe 14.3% vs. 11.4%,\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20091.000), and hospital stay (14 vs. 13 days;\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.339) did not differ; neither arm had splenic hilar fistula or No. 10 metastasis. Robotic gastrectomy was associated with less blood loss, lower pancreatic enzyme elevation, and higher No. 10 nodal yield than laparoscopy, without added morbidity or longer stay. Prospective, multicenter studies are needed to confirm and clarify the oncological rationale for routine No. 10 dissection.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial registration:<\/jats:bold>\n                    University Hospital Medical Information Network (UMIN000032895).\n                  <\/jats:p>","DOI":"10.1007\/s11701-026-03942-0","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:55:58Z","timestamp":1789185358000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robotic versus laparoscopic gastrectomy with splenic hilar lymph node dissection: short-term outcomes from a propensity score-matched study"],"prefix":"10.1007","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7268-6413","authenticated-orcid":false,"given":"Hironori","family":"Ohdaira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junji","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yosuke","family":"Igarashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norihiko","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jungo","family":"Yasuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8371-082X","authenticated-orcid":false,"given":"Hiroya","family":"Enomoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eigoro","family":"Yamanouchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,12]]},"reference":[{"issue":"3","key":"3942_CR1","first-page":"209","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209\u2013249","journal-title":"CA Cancer J Clin"},{"key":"3942_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10120-022-01331-8","volume":"26","author":"Japanese Gastric Cancer Association","year":"2023","unstructured":"Japanese Gastric Cancer Association (2023) Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition). Gastric Cancer 26:1\u201325. https:\/\/doi.org\/10.1007\/s10120-022-01331-8","journal-title":"Gastric Cancer"},{"key":"3942_CR3","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1097\/SLA.0000000000001814","volume":"265","author":"T Sano","year":"2017","unstructured":"Sano T, Sasako M, Mizusawa J et al (2017) Randomized controlled trial to evaluate splenectomy in total gastrectomy for proximal gastric carcinoma. Ann Surg 265:277\u2013283. https:\/\/doi.org\/10.1097\/SLA.0000000000001814","journal-title":"Ann Surg"},{"issue":"2","key":"3942_CR4","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1002\/ags3.12413","volume":"5","author":"T Kinoshita","year":"2021","unstructured":"Kinoshita T, Okayama T (2021) Is splenic hilar lymph node dissection necessary for proximal gastric cancer surgery? Ann Gastroenterol Surg 5(2):173\u2013182. https:\/\/doi.org\/10.1002\/ags3.12413","journal-title":"Ann Gastroenterol Surg"},{"issue":"2","key":"3942_CR5","first-page":"146","volume":"4","author":"S Kitano","year":"1994","unstructured":"Kitano S, Iso Y, Moriyama M, Sugimachi K (1994) Laparoscopy-assisted Billroth I gastrectomy. Surg Laparosc Endosc 4(2):146\u2013148","journal-title":"Surg Laparosc Endosc"},{"key":"3942_CR6","doi-asserted-by":"publisher","first-page":"e6","DOI":"10.1016\/j.jamcollsurg.2008.04.027","volume":"207","author":"WJ Hyung","year":"2008","unstructured":"Hyung WJ, Lim JS, Song J, Choi SH, Noh SH (2008) Laparoscopic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer. J Am Coll Surg 207:e6\u2013e11. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2008.04.027","journal-title":"J Am Coll Surg"},{"key":"3942_CR7","doi-asserted-by":"publisher","first-page":"11376","DOI":"10.3748\/wjg.v20.i32.11376","volume":"20","author":"P Li","year":"2014","unstructured":"Li P, Huang CM, Zheng CH et al (2014) Laparoscopic spleen-preserving splenic hilar lymphadenectomy in 108 consecutive patients with upper gastric cancer. World J Gastroenterol 20:11376\u201311383. https:\/\/doi.org\/10.3748\/wjg.v20.i32.11376","journal-title":"World J Gastroenterol"},{"key":"3942_CR8","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1007\/s11605-020-04538-1","volume":"24","author":"B Wang","year":"2020","unstructured":"Wang B, Son SY, Han SU (2020) A simple approach for splenic hilar lymphadenectomy during laparoscopic total gastrectomy for advanced gastric cancer: the SHINY maneuver. J Gastrointest Surg 24:1223\u20131227. https:\/\/doi.org\/10.1007\/s11605-020-04538-1","journal-title":"J Gastrointest Surg"},{"key":"3942_CR9","doi-asserted-by":"publisher","first-page":"2357","DOI":"10.1007\/s00464-019-06772-4","volume":"33","author":"K Yang","year":"2019","unstructured":"Yang K, Cho M, Roh CK et al (2019) Robotic spleen-preserving splenic hilar lymph node dissection during total gastrectomy for gastric cancer. Surg Endosc 33:2357\u20132363. https:\/\/doi.org\/10.1007\/s00464-019-06772-4","journal-title":"Surg Endosc"},{"key":"3942_CR10","doi-asserted-by":"publisher","first-page":"2483","DOI":"10.1007\/s13304-024-01880-w","volume":"76","author":"Y Ebihara","year":"2024","unstructured":"Ebihara Y, Kurashima Y, Shichinohe T, Hirano S (2024) Robotic spleen-preserving suprapancreatic and splenic hilar lymph node dissection using the preemptive retropancreatic approach in total gastrectomy for gastric cancer. Updates Surg 76:2483\u20132487. https:\/\/doi.org\/10.1007\/s13304-024-01880-w","journal-title":"Updates Surg"},{"issue":"4","key":"3942_CR11","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1007\/s10120-023-01389-y","volume":"26","author":"I Uyama","year":"2023","unstructured":"Uyama I, Suda K, Satoh S (2023) Robotic gastrectomy for gastric cancer: systematic review and future directions. Gastric Cancer 26(4):516\u2013530","journal-title":"Gastric Cancer"},{"issue":"6","key":"3942_CR12","first-page":"1302","volume":"24","author":"N Inaki","year":"2021","unstructured":"Inaki N, Etoh T, Ohyama T et al (2021) Safe implementation of robotic gastrectomy for gastric cancer under the requirements for universal health insurance coverage: a retrospective cohort study using a nationwide registry database in Japan. Gastric Cancer 24(6):1302\u20131312","journal-title":"Gastric Cancer"},{"key":"3942_CR13","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1097\/01.SLA.0000133083.54934.AE","volume":"240","author":"D Dindo","year":"2004","unstructured":"Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205\u2013213. https:\/\/doi.org\/10.1097\/01.SLA.0000133083.54934.AE","journal-title":"Ann Surg"},{"key":"3942_CR14","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1002\/pst.433","volume":"10","author":"PC Austin","year":"2011","unstructured":"Austin PC (2011) Optimal caliper widths for propensity-score matching when estimating differences in means and differences in proportions in observational studies. Pharm Stat 10:150\u2013161. https:\/\/doi.org\/10.1002\/pst.433","journal-title":"Pharm Stat"},{"key":"3942_CR15","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1080\/00273171.2011.568786","volume":"46","author":"PC Austin","year":"2011","unstructured":"Austin PC (2011) An introduction to propensity score methods for reducing the effects of confounding in observational studies. Multivar Behav Res 46:399\u2013424. https:\/\/doi.org\/10.1080\/00273171.2011.568786","journal-title":"Multivar Behav Res"},{"issue":"3","key":"3942_CR16","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1024\/1023-9332.8.3.106","volume":"8","author":"P Buchmann","year":"2002","unstructured":"Buchmann P, Dincler S (2002) Learning curve in surgery: possibilities and limits of this method. Swiss Surg 8(3):106\u2013109. https:\/\/doi.org\/10.1024\/1023-9332.8.3.106","journal-title":"Swiss Surg"},{"issue":"12","key":"3942_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3310\/hta5120","volume":"5","author":"CR Ramsay","year":"2001","unstructured":"Ramsay CR, Grant AM, Wallace SA, Garthwaite PH, Monk AF, Russell IT (2001) Statistical assessment of the learning curves of health technologies. Health Technol Assess 5(12):1\u201379","journal-title":"Health Technol Assess"},{"key":"3942_CR18","doi-asserted-by":"publisher","first-page":"6568","DOI":"10.1007\/s00464-020-08154-7","volume":"35","author":"Y Shirakawa","year":"2021","unstructured":"Shirakawa Y, Noma K, Kunitomo T et al (2021) Initial introduction of robot-assisted, minimally invasive esophagectomy using the microanatomy-based concept in the upper mediastinum. Surg Endosc 35:6568\u20136576. https:\/\/doi.org\/10.1007\/s00464-020-08154-7","journal-title":"Surg Endosc"},{"issue":"10","key":"3942_CR19","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.1016\/j.ejso.2013.09.011","volume":"40","author":"HI Kim","year":"2014","unstructured":"Kim HI, Park MS, Song KJ, Woo Y, Hyung WJ (2014) Rapid and safe learning of robotic gastrectomy for gastric cancer: multidimensional analysis in a comparison with laparoscopic gastrectomy. Eur J Surg Oncol 40(10):1346\u20131354. https:\/\/doi.org\/10.1016\/j.ejso.2013.09.011","journal-title":"Eur J Surg Oncol"},{"issue":"9","key":"3942_CR20","doi-asserted-by":"publisher","first-page":"1126","DOI":"10.1093\/bjs\/znab090","volume":"108","author":"S Lee","year":"2021","unstructured":"Lee S, Hyung WJ, Ri M et al (2021) Learning curve of robotic distal and total gastrectomy. Br J Surg 108(9):1126\u20131132. https:\/\/doi.org\/10.1093\/bjs\/znab090","journal-title":"Br J Surg"},{"key":"3942_CR21","doi-asserted-by":"publisher","first-page":"954","DOI":"10.1001\/jamasurg.2021.3182","volume":"156","author":"T Ojima","year":"2021","unstructured":"Ojima T, Nakamura M, Hayata K et al (2021) Short-term outcomes of robotic gastrectomy vs laparoscopic gastrectomy for patients with gastric cancer: a randomized clinical trial. JAMA Surg 156:954\u2013963. https:\/\/doi.org\/10.1001\/jamasurg.2021.3182","journal-title":"JAMA Surg"}],"container-title":["Journal of Robotic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03942-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11701-026-03942-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-026-03942-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T03:56:00Z","timestamp":1789185360000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11701-026-03942-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,12]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3942"],"URL":"https:\/\/doi.org\/10.1007\/s11701-026-03942-0","relation":{},"ISSN":["1863-2491"],"issn-type":[{"value":"1863-2491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,12]]},"assertion":[{"value":"15 August 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study protocol was reviewed and approved by the Research Ethics Board of the International University of Health and Welfare (approval no. 21-B-22), under a broader institutional protocol addressing clinicopathological factors and survival after minimally invasive gastrointestinal surgery\u2014including robot-assisted procedures for gastric, esophageal, and colorectal cancer. The study was conducted in accordance with the World Medical Association\u2019s Declaration of Helsinki and was prospectively registered (UMIN000032895).","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Given the retrospective, non-interventional design, the ethics board formally waived the requirement for prospective individual informed consent. Patients were instead informed through a publicly posted opt-out notice, and anyone who declined participation was excluded from the analysis.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable; no individually identifiable patient data or images are included in this manuscript.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"982"}}