Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallstones, acute cholecystitis, and acute gallstone pancreatitis. In recent years, the development and diffusion of robotic surgery have provided surgeons with the opportunity to apply this innovative approach to cholecystectomy, yielding interesting results. However, as with any new surgical technique, robotic cholecystectomy (RC) has met with skepticism within the surgical community. Beyond the understandable concerns regarding increased costs, some authors have claimed that RC is associated with a higher complication rate compared to LC. We reviewed the existing literature on this subject, discussing the limitations and strengths of the most significant publications and critically analyzing them. The analysis of the literature indicates that RC is safe and effective, with no definitive evidence of its inferiority compared to LC. Some of the published papers are of low quality and biased, even with significant sample sizes. Furthermore, we believe that comparing an established technique like LC with a new and not yet standardized one such as RC is somewhat illogical. RC represents a significant advance in minimally invasive surgery and should be viewed as an opportunity to familiarize oneself with the robotic device and to enhance the surgeon’s skills in preparation for more complex robotic operations. The robotic approach can be beneficial in selected cases of cholecystectomy where fine dissection is required. With further reductions in costs, RC could become the future gold standard for benign gallbladder disorders.

Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallstones, acute cholecystitis, and acute gallstone pancreatitis. In recent years, the development and diffusion of robotic surgery have provided surgeons with the opportunity to apply this innovative approach to cholecystectomy, yielding interesting results. However, as with any new surgical technique, robotic cholecystectomy (RC) has met with skepticism within the surgical community. Beyond the understandable concerns regarding increased costs, some authors have claimed that RC is associated with a higher complication rate compared to LC. We reviewed the existing literature on this subject, discussing the limitations and strengths of the most significant publications and critically analyzing them. The analysis of the literature indicates that RC is safe and effective, with no definitive evidence of its inferiority compared to LC. Some of the published papers are of low quality and biased, even with significant sample sizes. Furthermore, we believe that comparing an established technique like LC with a new and not yet standardized one such as RC is somewhat illogical. RC represents a significant advance in minimally invasive surgery and should be viewed as an opportunity to familiarize oneself with the robotic device and to enhance the surgeon’s skills in preparation for more complex robotic operations. The robotic approach can be beneficial in selected cases of cholecystectomy where fine dissection is required. With further reductions in costs, RC could become the future gold standard for benign gallbladder disorders.

Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallstones, acute cholecystitis, and acute gallstone pancreatitis. In recent years, the development and diffusion of robotic surgery have provided surgeons with the opportunity to apply this innovative approach to cholecystectomy, yielding interesting results. However, as with any new surgical technique, robotic cholecystectomy (RC) has met with skepticism within the surgical community. Beyond the understandable concerns regarding increased costs, some authors have claimed that RC is associated with a higher complication rate compared to LC. We reviewed the existing literature on this subject, discussing the limitations and strengths of the most significant publications and critically analyzing them. The analysis of the literature indicates that RC is safe and effective, with no definitive evidence of its inferiority compared to LC. Some of the published papers are of low quality and biased, even with significant sample sizes. Furthermore, we believe that comparing an established technique like LC with a new and not yet standardized one such as RC is somewhat illogical. RC represents a significant advance in minimally invasive surgery and should be viewed as an opportunity to familiarize oneself with the robotic device and to enhance the surgeon’s skills in preparation for more complex robotic operations. The robotic approach can be beneficial in selected cases of cholecystectomy where fine dissection is required. With further reductions in costs, RC could become the future gold standard for benign gallbladder disorders.

Preoperative chemo- and radiotherapeutic strategies followed by surgery are currently a standard approach for treating locally advanced gastric and esophagogastric junction cancer in Western countries. However, in a large number of cases, the tumor is extremely resistant to these treatments and the patients are exposed to unnecessary toxicity and delayed surgical therapy. The current clinical trials evaluating the combination of preoperative systemic therapies with modern targeted and immunotherapeutic agents represent a unique opportunity for identifying predictive biomarkers of response to select patients that would benefit the most from these treatments. However, it is of utmost importance that these potential biomarkers are corroborated by extensive preclinical and translational research. The aim of this review article is to present the most promising biomarkers of response to classic chemotherapeutic, anti-HER2, antiangiogenic, and immunotherapeutic agents that can be potentially useful for personalized preoperative systemic therapies in gastric cancer patients.
Biomarkers ; Esophagogastric Junction ; Humans ; Microsatellite Instability ; Receptor, Fibroblast Growth Factor, Type 3 ; Stomach Neoplasms ; Translational Medical Research