Over the past three decades years, the treatment of gastric cancer has shifted from traditional open surgery to minimally invasive surgery. Cutting-edge technologies such as three-dimensional and 4K ultra-high-definition imaging systems, indocyanine green fluorescence navigation, and robotic surgical systems have been widely used in clinical practice, facilitating precise intraoperative anatomy and lymph node dissection. For early gastric cancer, endoscopic submucosal dissection, as the standard surgical procedure, can improve the 5-year survival rate and reduce the local recurrence rate. For locally advanced gastric cancer, neoadjuvant chemotherapy combined with minimally invasive surgery has increased the R0 resection rate and improved the prognosis of patients. For advanced gastric cancer, conversion therapy combined with minimally invasive surgery has brought hope for extended survival to patients with stage Ⅳ disease, and the application of immune checkpoint inhibitors has further promoted the progress of advanced gastric cancer treatment. With the advancement of technology and the improvement of policies, artificial intelligence and 5G remote surgery have become important directions in the minimally invasive surgical treatment of gastric cancer. In the future, it is necessary to accumulate evidence through multi-center prospective studies, optimize the evaluation of function-preserving surgery, develop cross-platform artificial intelligence tools, conduct cost-benefit analyses, and resolve ethical and legal disputes to promote the development of minimally invasive surgical treatment of gastric cancer towards precision and intelligence, achieving a dual improvement in efficacy and accessibility.
Zheng et al. (Sat,) studied this question.