Robotic utilization in esophageal cancer surgery

Abstract

Minimally invasive esophagectomy (MIE) was designed to reduce surgical trauma, resulting in lower rates of morbidity and mortality. MIE has been shown to decrease blood loss, reduce postoperative complications, and shorten hospital stay, with comparable oncological results. In 2003 the robot–assisted thoraco–laparoscopic esophagectomy (RAMIE) was developed at UMC Utrecht. Robot–assisted thoraco-laparoscopic esophagectomy facilitates complex minimally invasive procedures with an enlarged, 3–dimensional field of view. The articulated instruments allow dissection with 7° of freedom. RAMIE with 2–field lymphadenectomy was analyzed in consecutive cohorts of more than 180 patients. The procedure was shown to be feasible and safe in Western patients with esophageal cancer. Furthermore, a high percentage of R0 radical resections with adequate lymphadenectomy resulted in adequate local control, a low percentage of local recurrence, and favorable overall survival.