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Robot-Assisted Ivor Lewis Esophagectomy

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Atlas of Minimally Invasive and Robotic Esophagectomy

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Abstract

Esophageal carcinoma is the eighth most common cancer worldwide and the sixth most common cause of cancer-related death. Although squamous cell carcinoma (ESCC) represents the most common histology, in the United States and many other Western countries, the incidence rate of adenocarcinoma (EAC) now exceeds that of ESCC, and this is expected to only increase. Most EACs affect the lower third of the esophagus and gastroesophageal junction, and since the location of these tumors generally does not require removal of the entire esophagus, partial esophagectomy with intrathoracic anastomosis is increasingly favored among thoracic surgeons. Furthermore, the majority of surgically resectable patients present with locoregionally advanced stage requiring induction chemo- or chemoradiation therapy up front, which may lessen the reliability of the stomach conduit for anastomosis in the neck. Therefore, over the last decade, there has been a shift in the approach to esophagectomy away from transhiatal and three-hole (McKeown) techniques toward a transthoracic (Ivor Lewis) approach. Furthermore, this trend has been observed for both open esophagectomy and minimally invasive esophagectomy (MIE). Because performance of MIE with intrathoracic anastomosis is technically complex, particularly with respect to the performance of the anastomosis, the advent of robotics has delivered greater dexterity with a minimally invasive approach and may overcome some of the technical limitations inherent in “straight stick” laparoscopic/thoracoscopic approaches. A recent consensus statement recommended standardizing the nomenclature for esophagectomy according to procedure and approach; therefore, robotic-assisted Ivor Lewis esophagectomy is referred to as ILER.

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References

  1. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Pineros M, et al. Global cancer observatory. Lyon: International Agency for Research on Cancer; 2018. Available from: https://gco.iarc.fr/today

    Google Scholar 

  2. Arnold M, Laversanne M, Brown LM, Devesa SS, Bray F. Predicting the future burden of esophageal cancer by histological subtype: international trends in incidence up to 2030. Am J Gastroenterol. 2017;112(8):1247–55.

    Article  Google Scholar 

  3. Haverkamp L, Seesing MF, Ruurda JP, Boone J, Hillegersberg RV. Worldwide trends in surgical techniques in the treatment of esophageal and gastroesophageal junction cancer. Dis Esophagus. 2017;30(1):1–7.

    CAS  PubMed  Google Scholar 

  4. Cerfolio RJ, Laliberte AS, Blackmon S, Ruurda JP, van Hillegersberg R, Sarkaria I, et al. Minimally invasive esophagectomy: a consensus statement. Ann Thorac Surg. 2020;110(4):1417–26.

    Google Scholar 

  5. Egberts JH, Biebl M, Perez DR, Mees ST, Grimminger PP, Muller-Stich BP, et al. Robot-assisted oesophagectomy: recommendations towards a standardised Ivor Lewis procedure. J Gastrointest Surg. 2019;23(7):1485–92. https://doi.org/10.1007/s11605-019-04207-y. Epub 2019 Apr 1.

    Article  PubMed  Google Scholar 

  6. Sarkaria IS, Bains MS, Finley DJ, Adusumilli PS, Huang J, Rusch VW, et al. Intraoperative near-infrared fluorescence imaging as an adjunct to robotic-assisted minimally invasive esophagectomy. Innovations (Phila). 2014;9(5):391–3. https://doi.org/10.1097/IMI.0000000000000091.

    Article  Google Scholar 

  7. Nobel T, Tan KS, Barbetta A, Adusumilli P, Bains M, Bott M, et al. Does pyloric drainage have a role in the era of minimally invasive esophagectomy? Surg Endosc. 2019;33(10):3218–27.

    Article  Google Scholar 

  8. Antonoff MB, Puri V, Meyers BF, Baumgartner K, Bell JM, Broderick S, et al. Comparison of pyloric intervention strategies at the time of esophagectomy: is more better? Ann Thorac Surg. 2014;97(6):1950–7. discussion 657-8.

    Article  Google Scholar 

  9. Marchese S, Qureshi YA, Hafiz SP, Dawas K, Turner P, Mughal MM, et al. Intraoperative pyloric interventions during oesophagectomy: a multicentre study. J Gastrointest Surg. 2018;22(8):1319–24.

    Article  Google Scholar 

  10. Arya S, Markar SR, Karthikesalingam A, Hanna GB. The impact of pyloric drainage on clinical outcome following esophagectomy: a systematic review. Dis Esophagus. 2015;28(4):326–35.

    Article  CAS  Google Scholar 

  11. Cerfolio RJ, Bryant AS, Canon CL, Dhawan R, Eloubeidi MA. Is botulinum toxin injection of the pylorus during Ivor Lewis [corrected] esophagogastrectomy the optimal drainage strategy? J Thorac Cardiovasc Surg. 2009;137(3):565–72.

    Article  Google Scholar 

  12. Eldaif SM, Lee R, Adams KN, Kilgo PD, Gruszynski MA, Force SD, et al. Intrapyloric botulinum injection increases postoperative esophagectomy complications. Ann Thorac Surg. 2014;97(6):1959–64. discussion 64-5.

    Article  Google Scholar 

  13. Kesler KA, Ramchandani NK, Jalal SI, Stokes SM, Mankins MR, Ceppa D, et al. Outcomes of a novel intrathoracic esophagogastric anastomotic technique. J Thorac Cardiovasc Surg. 2018;156(4):1739–45 e1.

    Article  Google Scholar 

  14. van Boxel GI, Kingma BF, Voskens FJ, Ruurda JP, van Hillegersberg R. Robotic-assisted minimally invasive esophagectomy: past, present and future. J Thorac Dis. 2020;12(2):54–62. https://doi.org/10.21037/jtd.2019.06.75.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Hagen JA. A novel intrathoracic esophagogastric anastomotic technique: potential benefit for patients undergoing a robotic-assisted minimally invasive esophagectomy. J Thorac Cardiovasc Surg. 2018;156(4):1746–7. https://doi.org/10.1016/j.jtcvs.2018.05.116. Epub Jun 23.

    Article  PubMed  Google Scholar 

  16. Price TN, Nichols FC, Harmsen WS, Allen MS, Cassivi SD, Wigle DA, et al. A comprehensive review of anastomotic technique in 432 esophagectomies. Ann Thorac Surg. 2013;95(4):1154–60. discussion 60-1.

    Article  Google Scholar 

  17. Blackmon SH, Correa AM, Wynn B, Hofstetter WL, Martin LW, Mehran RJ, et al. Propensity-matched analysis of three techniques for intrathoracic esophagogastric anastomosis. Ann Thorac Surg. 2007;83(5):1805–13. discussion 13.

    Article  Google Scholar 

  18. Law S, Fok M, Chu KM, Wong J. Comparison of hand-sewn and stapled esophagogastric anastomosis after esophageal resection for cancer: a prospective randomized controlled trial. Ann Surg. 1997;226(2):169–73.

    Article  CAS  Google Scholar 

  19. Deng XF, Liu QX, Zhou D, Min JX, Dai JG. Hand-sewn vs linearly stapled esophagogastric anastomosis for esophageal cancer: a meta-analysis. World J Gastroenterol. 2015;21(15):4757–64.

    Article  Google Scholar 

  20. Plat VD, Stam WT, Schoonmade LJ, Heineman DJ, van der Peet DL, Daams F. Implementation of robot-assisted Ivor Lewis procedure: robotic hand-sewn, linear or circular technique? Am J Surg. 2019;26(19):31545–4.

    Google Scholar 

  21. Zhang H, Wang Z, Zheng Y, Geng Y, Wang F, Chen LQ, et al. Robotic side-to-side and end-to-side stapled esophagogastric anastomosis of Ivor Lewis esophagectomy for cancer. World J Surg. 2019;43(12):3074–82. https://doi.org/10.1007/s00268-019-5133-5.

    Article  PubMed  Google Scholar 

  22. Sarkaria IS, Rizk NP. Robotic-assisted minimally invasive esophagectomy: the Ivor Lewis approach. Thorac Surg Clin. 2014;24(2):211–22.

    Article  Google Scholar 

  23. Grimminger PP, Hadzijusufovic E, Babic B, van der Sluis PC, Lang H. Innovative fully robotic 4-arm Ivor Lewis esophagectomy for esophageal cancer (RAMIE4). Dis Esophagus. 2020;33(3).(pii):5450338. https://doi.org/10.1093/dote/doz015.

  24. Amaral M, Pimiento J, Fontaine JP. Robotic esophagectomy: the Moffitt Cancer Center experience. Ann Cardiothorac Surg. 2017;6(2):186–9. https://doi.org/10.21037/acs.2017.03.21.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Egberts JH, Stein H, Aselmann H, Hendricks A, Becker T. Fully robotic da Vinci Ivor-Lewis esophagectomy in four-arm technique-problems and solutions. Dis Esophagus. 2017;30(12):1–9. https://doi.org/10.1093/dote/dox098.

    Article  PubMed  Google Scholar 

  26. Cerfolio RJ, Wei B, Hawn MT, Minnich DJ. Robotic esophagectomy for cancer: early results and lessons learned. Semin Thorac Cardiovasc Surg. 2016;28(1):160–9.

    Article  Google Scholar 

  27. Gooszen JAH, Slaman AE, van Dieren S, Gisbertz SS, van Berge Henegouwen MI. Incidence and treatment of symptomatic diaphragmatic hernia after esophagectomy for cancer. Ann Thorac Surg. 2018;106(1):199–206.

    Article  Google Scholar 

  28. Gust L, Nafteux P, Allemann P, Tuech JJ, El Nakadi I, Collet D, et al. Hiatal hernia after oesophagectomy: a large European survey. Eur J Cardiothorac Surg. 2019;55(6):1104–12.

    Article  Google Scholar 

  29. de la Fuente SG, Weber J, Hoffe SE, Shridhar R, Karl R, Meredith KL. Initial experience from a large referral center with robotic-assisted Ivor Lewis esophagogastrectomy for oncologic purposes. Surg Endosc. 2013;27(9):3339–47.

    Article  Google Scholar 

  30. Hernandez JM, Dimou F, Weber J, Almhanna K, Hoffe S, Shridhar R, et al. Defining the learning curve for robotic-assisted esophagogastrectomy. J Gastrointest Surg. 2013;17(8):1346–51.

    Article  Google Scholar 

  31. Trugeda S, Fernandez-Diaz MJ, Rodriguez-Sanjuan JC, Palazuelos CM, Fernandez-Escalante C, Gomez-Fleitas M. Initial results of robot-assisted Ivor-Lewis oesophagectomy with intrathoracic hand-sewn anastomosis in the prone position. Int J Med Robot. 2014;10(4):397–403. https://doi.org/10.1002/rcs.587. Epub 2014 Apr 29.

    Article  CAS  PubMed  Google Scholar 

  32. Abbott A, Shridhar R, Hoffe S, Almhanna K, Doepker M, Saeed N, et al. Robotic assisted Ivor Lewis esophagectomy in the elderly patient. J Gastrointest Oncol. 2015;6(1):31–8.

    PubMed  PubMed Central  Google Scholar 

  33. Hodari A, Park KU, Lace B, Tsiouris A, Hammoud Z. Robot-assisted minimally invasive Ivor Lewis esophagectomy with real-time perfusion assessment. Ann Thorac Surg. 2015;100(3):947–52. https://doi.org/10.1016/j.athoracsur.2015.03.084. Epub Jun 24.

    Article  PubMed  Google Scholar 

  34. Sarkaria IS, Rizk NP, Grosser R, Goldman D, Finley DJ, Ghanie A, et al. Attaining proficiency in robotic-assisted minimally invasive esophagectomy while maximizing safety during procedure development. Innovations (Phila). 2016;11(4):268–73.

    Article  Google Scholar 

  35. Okusanya OT, Sarkaria IS, Hess NR, Nason KS, Sanchez MV, Levy RM, et al. Robotic assisted minimally invasive esophagectomy (RAMIE): the University of Pittsburgh Medical Center initial experience. Ann Cardiothorac Surg. 2017;6(2):179–85. https://doi.org/10.21037/acs.2017.03.12.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Wang WP, Chen LQ, Zhang HL, Yang YS, He SL, Yuan Y, et al. Modified intrathoracic esophagogastrostomy with minimally invasive robot-assisted Ivor-Lewis esophagectomy for cancer. Dig Surg. 2019;36(3):218–25. https://doi.org/10.1159/000495361. Epub 2018 Dec 5.

    Article  PubMed  Google Scholar 

  37. Sarkaria IS, Rizk NP, Goldman DA, Sima C, Tan KS, Bains MS, et al. Early quality of life outcomes after robotic-assisted minimally invasive and open esophagectomy. Ann Thorac Surg. 2019;108(3):920–8. https://doi.org/10.1016/j.athoracsur.2018.11.075. Epub 9 Apr 23.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Wang F, Zhang H, Zheng Y, Wang Z, Geng Y, Wang Y. Intrathoracic side-to-side esophagogastrostomy with a linear stapler and barbed suture in robot-assisted Ivor Lewis esophagectomy. J Surg Oncol. 2019;120(7):1142–7. https://doi.org/10.1002/jso.25698. Epub 2019 Sep 18.

    Article  PubMed  PubMed Central  Google Scholar 

  39. van der Sluis PC, Tagkalos E, Hadzijusufovic E, Babic B, Uzun E, van Hillegersberg R, et al. Robot-assisted minimally invasive esophagectomy with intrathoracic anastomosis (Ivor Lewis): promising results in 100 consecutive patients (the European experience). J Gastrointest Surg. 2020;18(10):019–04510.

    Google Scholar 

  40. Zhang Y, Han Y, Gan Q, Xiang J, Jin R, Chen K, et al. Early outcomes of robot-assisted versus thoracoscopic-assisted Ivor Lewis esophagectomy for esophageal cancer: a propensity score-matched study. Ann Surg Oncol. 2019;26(5):1284–91. https://doi.org/10.1245/s10434-019-07273-3. Epub 2019 Mar 6.

    Article  PubMed  Google Scholar 

  41. Meredith K, Blinn P, Maramara T, Takahashi C, Huston J, Shridhar R. Comparative outcomes of minimally invasive and robotic-assisted esophagectomy. Surg Endosc. 2020;34(2):814–20. https://doi.org/10.1007/s00464-019-6834-7. Epub 2019 Jun 10.

    Article  PubMed  Google Scholar 

  42. Halpern AL, Friedman C, Torphy RJ, Al-Musawi MH, Mitchell JD, Scott CD, et al. Conversion to open surgery during minimally invasive esophagectomy portends worse short-term outcomes: an analysis of the National Cancer Database. Surg Endosc. 2019;7(10):019–07124.

    Google Scholar 

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Authors and Affiliations

  1. Department of Thoracic and Cardiovascular Surgery, Division of Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    David C. Rice

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  1. David C. Rice
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  1. Division of Thoracic Surgery Department of Surgery and Cardiothoracic Surgery Weill Cornell Medical College Department of Surgery, Houston Methodist Hospital, Houston, TX, USA

    Min P. Kim

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Rice, D.C. (2021). Robot-Assisted Ivor Lewis Esophagectomy. In: Kim, M.P. (eds) Atlas of Minimally Invasive and Robotic Esophagectomy. Springer, Cham. https://doi.org/10.1007/978-3-030-55669-3_4

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  • DOI: https://doi.org/10.1007/978-3-030-55669-3_4

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