Single-port plus two additional ports robot-assisted distal gastrectomy using the Chinese-developed KangDuo SR2000 system: A case report

BACKGROUNDReduced-port robotic gastrectomy aims to minimize abdominal wall trauma while preserving the dexterity and stable traction provided by a multi-arm platform.Dedicated single-port systems have demonstrated feasibility in gastric surgery, but limited assistant access, instrument selection, countertraction, and platform costs may restrict broader adoption.We report a single-port plus two additional ports (SP + 2) distal gastrectomy using the Chinese-developed KangDuo SR2000 system.CASE SUMMARY A 37-year-old man with poorly differentiated gastric antral adenocarcinoma was staged as cT3N2M0.On January 19, 2026, he underwent SP + 2 robotic distal gastrectomy with D2 lymph node dissection and Billroth II reconstruction using the KangDuo SR2000.The surgery took 240 minutes and an estimated blood loss of 50 milliliters without any conversion or surgical complications.In pathologic assessment, there was subserosal invasion, and 12 out of 17 resected lymph nodes had metastasis.Negative margins were found at the time of the resection with the pathologic stage being pT3N3aM0 (AJCC stage IIIB).Chemotherapy was administered adjuvantly for 6 courses between February 23 and June 22.During the first 4 courses, the patient was given a combination of oxaliplatin and S-1.Oxaliplatin was stopped at the 4 cycles because the patient declined any further administration of intravenous chemotherapy, with 5 and 6 cycles made up of only S-1.Adverse effects of treatment involved fatigue, nausea, a decrease in body weight by 1 kg, grade 2 neutropenia, diarrhea, and decreased appetite.At six months, computed tomography showed no evidence of metastasis.The patient remained well, without symptoms of anastomotic stenosis or clinically significant bile reflux. CONCLUSIONThis particular case shows that SP + 2 distal gastrectomy can be performed using the KangDuo SR2000.However, it establishes technical feasibility in only one patient.Larger studies are required to evaluate the safety and long-term oncological outcomes of this approach.