Surgical Endoscopy And Other Interventional Techniques

, Volume 20, Issue 9, pp 1435–1439

First experience with robot-assisted thoracoscopic esophagolymphadenectomy for esophageal cancer

  • R. van Hillegersberg
  • J. Boone
  • W. A. Draaisma
  • I. A. M. J. Broeders
  • M. J. M. M. Giezeman
  • I. H. M. Borel Rinkes
Article

DOI: 10.1007/s00464-005-0674-8

Cite this article as:
van Hillegersberg, R., Boone, J., Draaisma, W.A. et al. Surg Endosc (2006) 20: 1435. doi:10.1007/s00464-005-0674-8

Abstract

Background

Transthoracic esophagectomy with extended lymph node dissection is associated with higher morbidity rates than transhiatal esophagectomy. This morbidity rate could be reduced by the use of minimally invasive techniques. The feasibility of robot-assisted thoracoscopic esophagectomy (RTE) with mediastinal lymphadenectomy was assessed prospectively.

Methods

This study investigated 21 consecutive patients with esophageal cancer who underwent RTE using the Da Vinci™ robotic system. Continuity was restored with a gastric conduit and a cervical anastomosis.

Results

A total of 18 (86%) procedures were completed thoracoscopically. The operating time for the thoracoscopic phase was 180 min (range, 120–240 min), and the median blood loss was 400 ml (range, 150–700 ml). A median of 20 (range, 9–30) lymph nodes were retrieved. The median intensive care unit stay was 4 days (range, 1–129 days), and the hospital stay was 18 days (range, 11–182 days). Pulmonary complications occurred in 10 patients (48%), and one patient (5%) died of a tracheoneoesophageal fistula.

Conclusions

In this initial experience, robot-assisted thoracoscopic esophagectomy was found to be feasible, providing an effective lymphadenectomy with low blood loss. Standardization of the technique and increased experience should reduce the complication rate, which is in the range of the rate for open transthoracic dissection.

Keywords

Oesophageal cancer Lymphadenectomy Mediastinal lymphadenectomy Robot-assisted thoracoscopic esophagectomy Minimally invasive surgery 

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • R. van Hillegersberg
    • 1
  • J. Boone
    • 1
  • W. A. Draaisma
    • 1
  • I. A. M. J. Broeders
    • 1
  • M. J. M. M. Giezeman
    • 2
  • I. H. M. Borel Rinkes
    • 1
  1. 1.Department of SurgeryUniversity Medical Center UtrechtUtrechtThe Netherlands
  2. 2.Department of AnaesthesiologyUniversity Medical Center UtrechtUtrechtThe Netherlands

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