Minimally Invasive Robotic and Laparoscopic Gastrectomy: A new ray of hope for gastric cancer

The stomach is a muscular J-shaped sac-like structure, mainly acts as reservoir for the food, located in the upper and left part of abdomen and a crucial part of the Digestive organ of gastrointestinal system. It produces enzymes (Substances that create chemical reactions) and acids (digestive juices). This mix of enzymes and digestive juices breaks down food so it can pass to our small intestine(duodenum)

Gastric cancer, also referred to as stomach cancer, can happen anywhere, in any part of the stomach (Fundus, Body, also called proximal stomach and Antrum and Pylorus also called Distal part of stomach)– where abnormal growth of malignant cells, invading the stomach and adjacent and distal organs like Liver, Lung, peritoneum and Bone etc

Symptoms of Gastric Cancer

The prominent symptoms of gastric cancer include:

· Difficulty swallowing

· Feeling full or bloated even after eating small amounts of food

· Heartburn or acidity

· Indigestion coupled with nausea and vomiting

· Severe pain in the stomach

· Unintentional weight loss

Causes of Gastric Cancer

There is no definite reason for what could cause stomach cancer. However, the risk factors that can trigger this ailment include

· Chronic Gastroesophageal Reflux Disease

· Overweight

· Consumption of low fibre diet

· Poor eating habits like intake of food high on salts, deep fries

· Family history

· Infection with Helicobacter pylori

· Chronic gastritis

· Smoking

· Stomach polyps

Diagnosis

The diagnosis of gastric cancer is made by running various tests, including blood tests, and imaging tests like endoscopic ultrasound, CT, PET-CT, biopsy, or Diagnostic Laparoscopy

Treatment

Surgery forms the first line of defence while combating gastric cancer (in early stages). In the last decade, the surgical techniques for treating stomach cancer have grown by leaps and bounds, providing significant relief for the patients Treating gastric cancer requires the exceptional expertise of Surgical oncologists (gastro intestinal surgeons) Over the last decade or more, the surgical treatment for gastric cancers witnessed unparalleled medical advancements, with the advent of minimally invasive procedures like Robotic, Laparoscopic Procedures that ensure a faster recovery.

What is Gastrectomy

Gastrectomy is defined as a full or partial removal of stomach for treating various medical conditions mainly for cancer

Gastrectomy is of four types – Total Gastrectomy, Subtotal Gastrectomy, Distal gastrectomy extended total gastrectomy (removal of distal food pipe) and Proximal gastrectomy

Advantages of Minimally Invasive Robotic, Laparoscopic Gastrectomy Procedures

Open surgery, laparoscopy, or Robotic Surgery; the principles involve the same – removing cancer and surrounding structures (in case of metastasis) without compromising on the cure. Minimally invasive surgical procedures provide a better outcome than open surgery in patients undergoing gastrectomy to treat gastric cancer. Extensively trained Gastrointestinal surgeons adopting either robotic or laparoscopic surgeries to ensure faster, safe and feasible alternatives to conservative open surgery.

Some of the advantages of minimally invasive procedures are:

· Decreased postoperative pain

· Shorter hospital stays and quicker recovery

· Minimal scarring

· Less strain on the immune system

· Smaller incisions

· Less chance of infection and hernia formation

How Is Laparoscopic Gastrectomy Performed?

Laparoscopic Gastrectomy is a widely recommended and adopted minimally invasive surgical procedure for eliminating cancer cells, even in the locally advanced stages of gastric cancer.

During the procedure, several small incisions (key holes) are made by the surgeons. Surgical instruments are sent inside for accessing the diseased part for its dissection and removal. The surgery aimed at eliminating the cancer cells, may take a little longer in comparison to open gastrectomy but the patient would recover faster due to less blood loss and pain. It has 2D vision and Ergonomics of instruments are difficult due to straight instruments

The patient would be able to resume regular duties and eat normally within a week or too

How Is Robotic Gastrectomy Performed?

Robotic-assisted gastrectomy is done by making a small incision (key hole) measuring up to 8 to 12mm, at the belly button and three other small incisions for assistant instruments at the upper abdomen. The surgeon sits at the console during the procedure, directing the robotic arms to perform the operation. These robotic arms work like human hands with absolute, accurate dexterity, finger movement, and wrist (done by surgeon hand actions transmitted through instruments with digital interactions). Even while performing the surgery, the surgeon could view a magnified, high-definition 3D view of the organs, enabling the surgeon to execute procedures like dissection, bowel connections, and stapling.

The advantages of Robotic Gastrectomy are aplenty. It is often recommended for removing Gastrointestinal stromal tumours, gastric adenocarcinoma, or even rare form of carcinoid or neuroendocrine tumours.

This procedure has lesser pain when compared to conventional open gastrectomy. Other benefits include:

· Lesser blood loss and less transfusions

· Reduced risk of infections

· Early starting of feed

· Faster return to normalcy

Since its inception, robotic surgeries have been carried out extensively in thousands of procedures across the globe. These techniques have gained widespread popularity for its positive impact on a patient’s recovery, fewer complications, and shorter stays at hospitals. If we focus on cancers in particular, these surgeries are widely used in the treatment of gastrointestinal cancers. To learn more about the benefits of robotic surgeries for gastric cancer care, you can consult an oncologist for further guidance.

 

 

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Scientists develop tool for treating diverse tumour cells found in metastatic gastric cancer

After defining extensive cellular heterogeneity, researchers from The University of Texas MD Anderson Cancer Center developed a tool that might be useful in stratifying patients with gastric cancer and directing them for more effective treatment strategies.

Based on the findings, published in Nature Medicine, the scientists developed and validated a gene expression signature capable of predicting patient survival better than other clinical features.

"In order to better treat patients with PC, we first have to understand the populations of metastatic cells in the peritoneal cavity," said co-corresponding author Linghua Wang, M.D., PhD, assistant professor of Genomic Medicine."This is the most detailed analysis of these cells performed to date. That is the power of single-cell analysis - we are able to look at every single cell and get a picture of the landscape," added Wang.

Peritoneal carcinomatosis is a condition in which cancer cells infiltrate and invade the peritoneal, or abdominal, cavity, adhering to the stomach and other organs.This can occur with other gastrointestinal cancers but is most commonly seen in patients with advanced gastric cancers, with roughly 45 per cent of patients diagnosed with PC at some point. The condition leads to significant fluid accumulation in the abdominal cavity, and patients have an overall survival of fewer than six months.

"PC represents a major unmet clinical need, as we don't have effective treatment options available for these patients," said co-corresponding author Jaffer Ajani, M.D., professor of Gastrointestinal Medical Oncology."Based on our findings, we need to move toward profiling these cells in each patient in order to offer more tailored treatment options," added Anjani.

For this study, the researchers isolated PC cells from ascites fluid collected from 20 patients with advanced gastric cancer. Ten of the patients were long-term survivors who survived more than one year after PC diagnosis, and 10 patients were short-term survivors who survived less than six months after PC diagnosis.

After performing single-cell RNA sequencing to analyze gene expression, the researchers were able to build the first "map" of PC cells, which describes the variety of cell types present and their functional states. The variability of cancer cells present within a tumour is known as intratumor heterogeneity, and it can lead to treatment failure and recurrence as distinct subtypes of cancer cells will respond differently to a given therapy.

The gene expression information also enabled the researchers to determine the origins of the PC cells, known as tumour cell lineage. They discovered that, although these were all gastric cancer cells, some appeared to originate from cells of the stomach while others more closely resembled cells of the intestine.

"The intriguing aspect is that, by classifying tumour cells based on lineage compositions, we noted two groups of patients," Wang said. "The more gastric-like PC cells had an aggressive phenotype and were associated with shorter survival. However, the more intestine-like PC cells were less aggressive, and patients had longer survival."

Based on these findings, the researchers developed a gene signature which robustly predicted patient survival better than various clinical features. They validated the signature in the second cohort of patients with advanced gastric cancer and PC and four large-scale localized gastric cancer cohorts totalling more than 1,300 patients.

Going forward, the researchers hope to validate the signature in prospective studies and to perform further analyses of PC cells in more patients to identify regulatory mechanisms of tumour cell lineage plasticity and new therapeutic targets that can be exploited to provide better treatment options for patients.

"This is an important first step toward a better understanding of the single-cell biology of these cancer cells, but we have more work to do. We foresee that understanding this heterogeneity could one day be used to guide clinical decision making that is most beneficial to each patient," Ajani said.

 This is only for your information, kindly take the advice of your doctor for medicines, exercises and so on.     

https://gscrochetdesigns.blogspot.com. one can see my crochet creations  
https://gseasyrecipes.blogspot.com. feel free to view for easy, simple and healthy recipes    
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