Feasibility analysis of robotic-assisted proximal gastrectomy with anterior esophagogastrostomy combined with stent-supported Toupet fundoplication (RAFT technique)

Abstract

Objective

To investigate the feasibility and technical points of a novel reconstruction technique following robotic-assisted proximal gastrectomy for gastric cancer, robotic-assisted proximal gastrectomy with anterior esophagogastrostomy combined with stent-supported Toupet fundoplication (RAFT Technique).

Methods

A patient diagnosed with esophagogastric junction (EGJ) adenocarcinoma (cT2N0M0) underwent da Vinci robot-assisted proximal gastrectomy. The reconstruction involved an anterior esophagogastric anastomosis combined with a Toupet fundoplication. Postoperative complications and quality of life were monitored and recorded.

Results

The procedure was completed successfully. The anastomosis was patent and tension-free, with an estimated intraoperative blood loss of 50 mL. To date, follow-up has revealed no complications such as anastomotic leakage, bleeding, stenosis, or reflux esophagitis, and no tumor recurrence has been observed.

Conclusion

The RAFT technique integrates the physiological advantages of anterior esophagogastrostomy with the antireflux efficacy of Toupet fundoplication, while maintaining procedural simplicity by requiring only a single primary anastomosis. Our initial experience confirms its safety and technical feasibility. Further clinical research is warranted to validate these findings.