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Robot-Assisted Oesophagectomy: Recommendations Towards a Standardised Ivor Lewis Procedure

  • Jan-Hendrik EgbertsEmail author
  • M. Biebl
  • D. R. Perez
  • S. T. Mees
  • P. P. Grimminger
  • B. P. Müller-Stich
  • H. Stein
  • H. Fuchs
  • C. J. Bruns
  • T. Hackert
  • H. Lang
  • J. Pratschke
  • J. Izbicki
  • J. Weitz
  • T. Becker
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Abstract

A considerable number of reports have been published on the feasibility, techniques, and early postoperative results of robotic-assisted oesophageal surgery. However, these are mostly smaller case series, suggesting that the robot-assisted Ivor Lewis procedure is still in the implementation phase and far from being standardised. Oesophageal surgeons from seven robotic university centres in Germany, experienced in both minimally invasive and robot-assisted minimally invasive surgery, took part in a workshop on robot-assisted surgery. An intensive exchange of opinions and experiences, followed by a step-by-step re-enactment of the operation in a cadaver lab, enabled us to develop a standardised robot-assisted Ivor Lewis surgical workflow, which is presented here. Systematic and objective comparison of experiences and results using a robot-assisted Ivor Lewis procedure has made it possible to develop a standardised surgical workflow that is now clinically applied in our centres. It is hoped that standardisation of this procedure will help to maintain patient safety, prevent medical errors, and facilitate the learning curve, while introducing robotic surgery into a centre.

Keywords

Oesophagectomy Ivor Lewis procedure RAMIE Robotic oesophagectomy 

Notes

Acknowledgements

Editorial support was provided by Deborah Nock (Medical WriteAway, Norwich, UK).

Author Contribution

All above listed authors contributed significantly to the conception and drafting of this work and approved this final version.

Compliance with Ethical Standards

Conflict of Interest

MB, JP, JI, JW, and TB received the da Vinci® Xi robotic surgical system from Intuitive Surgical Sàrl for the purpose of clinical research. JHE, DP, and PG are proctors for Intuitive Surgical.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  • Jan-Hendrik Egberts
    • 1
    Email author
  • M. Biebl
    • 2
  • D. R. Perez
    • 3
  • S. T. Mees
    • 4
  • P. P. Grimminger
    • 5
  • B. P. Müller-Stich
    • 6
  • H. Stein
    • 7
  • H. Fuchs
    • 8
  • C. J. Bruns
    • 8
  • T. Hackert
    • 6
  • H. Lang
    • 5
  • J. Pratschke
    • 2
  • J. Izbicki
    • 3
  • J. Weitz
    • 4
  • T. Becker
    • 1
  1. 1.Department for General, Visceral-, Thoracic-, Transplantation-, and Pediatric Surgery, Kurt Semm Center for Minimal Invasive and Robotic SurgeryUniversity Hospital Schleswig HolsteinKielGermany
  2. 2.Department for SurgeryCharite University HospitalBerlinGermany
  3. 3.Department of General, Visceral and Thoracic SurgeryUniversity Medical Center Hamburg-EppendorfHamburgGermany
  4. 4.Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav CarusTechnische Universität DresdenDresdenGermany
  5. 5.Department of General-, Visceral- and Transplant SurgeryUniversity Medical Center of the Johannes Gutenberg UniversityMainzGermany
  6. 6.Department of General, Visceral and Transplantations SurgeryUniversity of HeidelbergHeidelbergGermany
  7. 7.Department of Global Clinical DevelopmentIntuitive Surgical Inc.SunnyvaleUSA
  8. 8.Klinik und Poliklinik für Allgemein-, Viszeral- und TumorchirurgieUniversitätsklinikum KölnCologneGermany

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