Skip to main content
SpringerLink
Log in

Robot assisted minimally invasive esophagectomy: safety, perioperative morbidity and short-term oncological outcome—a single institution experience

  • Original Article
  • Published:
Journal of Robotic Surgery Aims and scope Submit manuscript

Abstract

Robot assisted minimally invasive esophagectomy (RAMIE) has evolved over the past decade to become procedure of choice at many centers all over the world. The objective of this study is to present our experience of robot assisted minimally invasive esophagectomy with respect to perioperative morbidity and short-term oncological outcomes and a comparison of the same to a cohort of our patients who underwent open Mckeown’s esophagectomy. This is a retrospective analysis of prospectively collected data of patients from October 2011 to October 2019. A total of 56 patients in open group and 58 patients in robotic group were enrolled. Upper and middle third was the most common site for open esophagectomy while middle and lower third was more common site for robotic esophagectomy (p < 0.0001). Median operative time was 340 min for open and 360 min for robotic esophagectomy (p = 0.004). A median of 16 lymph nodes were retrieved in either group. R0 resection was achieved in 86% in open and 97% in robotic group (p = 0.04). Median intensive care unit (ICU) stay (2 days versus 5 days) and median hospital stay (10.5 days versus 14.5 days) were both favoring for robotic group (p < 0.0001). Cardiac arrhythmias and pulmonary complications requiring ICU readmission occurred less frequently in patients undergoing robotic esophagectomy (p = 0.02). Two-year overall survival (p = 0.09) and 2-year disease-free survival (p = 0.32) was similar between the groups. RAMIE significantly reduced ICU as well as hospital stay and had oncological outcome similar to open Mckeown’s esophagectomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Availability of data and materials

Not applicable.

Code availability

Not applicable.

References

  1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (2021) Global cancer statistics: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. https://doi.org/10.3322/caac.21660

    Article  PubMed  Google Scholar 

  2. Cuschieri A, Shimi S, Banting S (1992) Endoscopic esophagectomy through a right thoracoscopic approach. J R Coll Surg Edinb 37(1):7–11

    CAS  PubMed  Google Scholar 

  3. Biere SS, van Berge Henegouwen MI, Maas KW, Bonavina L, Rosman C, Garcia JR, Gisbertz SS, Klinkenbijl JH, Hollmann MW, de Lange ES, Bonjer HJ, van der Peet DL, Cuesta MA (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 379(9829):1887–1892

    Article  Google Scholar 

  4. Mariette C, Markar SR, Dabakuyo-Yonli TS et al (2019) Hybrid minimally invasive esophagectomy for esophageal cancer. N Engl J Med 380:152–162

    Article  Google Scholar 

  5. Melvin WS, Needleman BJ, Krause KR, Schneider C, Wolf RK, Michler RE, Ellison EC (2002) Computer-enhanced robotic telesurgery. Initial experience in foregut surgery. Surg Endosc 16:1790–1792

    Article  CAS  Google Scholar 

  6. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213

    Article  Google Scholar 

  7. Ryan R, Gibbons D, Hyland JM, Treanor D, White A, Mulcahy HE, O’Donoghue DP, Moriarty M, Fennelly D, Sheahan K (2005) Pathological response following long-course neoadjuvant chemoradiotherapy for locally advanced rectal cancer. Histopathology 47(2):141–146

    Article  CAS  Google Scholar 

  8. van der Sluis PC, van der Horst S, May AM, Schippers C, Brosens LAA, Joore HCA, Kroese CC, Haj Mohammad N, Mook S, Vleggaar FP, Borel Rinkes IHM, Ruurda JP, van Hillegersberg R (2019) Robot-assisted minimally invasive thoracolaparoscopic esophagectomy versus open transthoracic esophagectomy for resectable esophageal cancer: a randomized controlled trial. Ann Surg 269(4):621–630

    Article  Google Scholar 

  9. Gong L, Jiang H, Yue J, Duan X, Tang P, Ren P, Zhao X, Liu X, Zhang X, Yu Z (2020) Comparison of the short-term outcomes of robot-assisted minimally invasive, video-assisted minimally invasive, and open esophagectomy. J Thorac Dis 12(3):916–924

    Article  Google Scholar 

  10. Sarkaria IS, Rizk NP, Finley DJ, Bains MS, Adusumilli PS, Huang J, Rusch VW (2013) Combined thoracoscopic and laparoscopic robotic-assisted minimally invasive esophagectomy using a four-arm platform: experience, technique and cautions during early procedure development. Eur J Cardiothorac Surg 43(5):e107–e115

    Article  Google Scholar 

  11. Kernstine KH, DeArmond DT, Shamoun DM, Campos JH (2007) The first series of completely robotic esophagectomies with three-field lymphadenectomy: initial experience. Surg Endosc 21(12):2285–2292

    Article  CAS  Google Scholar 

  12. Puntambekar SP, Rayate N, Joshi S, Agarwal G (2011) Robotic transthoracic esophagectomy in the prone position: experience with 32 patients with esophageal cancer. J Thorac Cardiovasc Surg 142(5):1283–1284

    Article  Google Scholar 

  13. Park SY, Kim DJ, Kang DR, Haam SJ (2017) Learning curve for robotic esophagectomy and dissection of bilateral recurrent laryngeal nerve nodes for esophageal cancer. Dis Esophagus 30(12):1–9

    Article  CAS  Google Scholar 

  14. Okusanya OT, Sarkaria IS, Hess NR, Nason KS, Sanchez MV, Levy RM, Pennathur A, Luketich JD (2017) Robotic assisted minimally invasive esophagectomy (RAMIE): the University of Pittsburgh Medical Center initial experience. Ann Cardiothorac Surg 6(2):179–185

    Article  Google Scholar 

  15. Luketich JD, Pennathur A, Franchetti Y, Catalano PJ, Swanson S, Sugarbaker DJ, De Hoyos A, Maddaus MA, Nguyen NT, Benson AB, Fernando HC (2015) Minimally invasive esophagectomy: results of a prospective phase II multicenter trial-the eastern cooperative oncology group (E2202) study. Ann Surg 261(4):702–707

    Article  Google Scholar 

  16. Meredith KL, Huston J, Briceno P, Shridhar R (2017) Short and long term outcomes with robotic assisted esophagectomy. JCO 35(4_suppl):125

    Article  Google Scholar 

Download references

Funding

The authors did not receive support from any organization for the submitted work.

Author information

Authors and Affiliations

  1. Department of GI and HPB Oncosurgery, Rajiv Gandhi Cancer Institute and Research Centre, Sector-5, Rohini, Delhi, 110085, India

    Assif Iqbal Sayed, Shaifali Goel, Abhishek Aggarwal & Shivendra Singh

  2. Department of GI and HPB Oncosurgery, Rajiv Gandhi Cancer Institute and Research Centre, Room no 3054, Ground floor, Sector -5, Rohini, Delhi, 110085, India

    Shivendra Singh

Authors
  1. Assif Iqbal Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shaifali Goel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abhishek Aggarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shivendra Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AIS: data acquisition, manuscript preparation, writing—original draft, manuscript review. SG: data acquisition, data analysis and interpretation, manuscript review. AA: statistical analysis, quality control of data and algorithms, manuscript review. SS: study concepts, study design, manuscript editing, manuscript review.

Corresponding author

Correspondence to Shivendra Singh.

Ethics declarations

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

Approved by ethics committee.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sayed, A.I., Goel, S., Aggarwal, A. et al. Robot assisted minimally invasive esophagectomy: safety, perioperative morbidity and short-term oncological outcome—a single institution experience . J Robotic Surg 16, 517–525 (2022). https://doi.org/10.1007/s11701-021-01274-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11701-021-01274-9

Keywords

Search

Navigation