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Journal of Robotic Surgery

, Volume 7, Issue 4, pp 325–332 | Cite as

Contribution of robotics to minimally invasive esophagectomy

  • Ismael Diez Del ValEmail author
  • Carlos Loureiro Gonzalez
  • Santiago Larburu Etxaniz
  • Julen Barrenetxea Asua
  • Saioa Leturio Fernandez
  • Sandra Ruiz Carballo
  • Eider Etxebarria Beitia
  • Patricia Perez de Villarreal
  • Lorena Hierro-Olabarria
  • Jose Esteban Bilbao Axpe
  • Jaime Jesus Mendez Martin
Original Article

Abstract

Robot-assisted surgery has the advantages of a three-dimensional view, versatility of instruments and better ergonomics. It allows fine dissection and difficult anastomoses in deep fields. Based on our experience, we try to define what are the main contributions of robotics to minimally invasive esophagectomy. From December 2009 to July 2012, we performed 24 minimally invasive esophagectomies (9 transhiatal, 5 Ivor-Lewis and 10 three-field), 16 of them robotically (8, 5 and 3, respectively). Eighteen patients (18/24 = 75 %) received neoadjuvant therapy. Nine patients (9/24 = 37.5 %) had symptomatic complications: 4 anastomotic leaks treated conservatively, one staple failure of the gastric plasty needing reoperation, one biliary peritonitis secondary to a gangrenous cholecystitis, one intrathoracic gastric migration after the only nonresectable case, one chylothorax and one patient with major cardiopulmonary complications. The median number of lymph nodes harvested was 12 ± 7. Median length of stay was 14 ± 13.5 days. Thirty-day mortality was nil. Complications were not related to the robot itself but to the complexity of both the technique and the patient. Although we found no advantages for the use of robotics during threefield minimally invasive esophagectomy, robotic mediastinal dissection during transhiatal esophagectomy can be performed safely under direct vision. Moreover, hand-sewn robotic-assisted technique in the prone position is promising and maybe the simplest way to carry out thoracic anastomosis during Ivor-Lewis esophagectomy

Keywords

Esophagus Robotic surgery Minimally invasive esophagectomy Ivor-Lewis Esophagectomy Transhiatal esophagectomy 

Notes

Acknowledgments

We have to thank Dr. Peter McCulloch, from the center for evidence-based medicine (Oxford, UK), for his critical review of the manuscript.

Conflict of interest

None.

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Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  • Ismael Diez Del Val
    • 1
    Email author
  • Carlos Loureiro Gonzalez
    • 1
  • Santiago Larburu Etxaniz
    • 2
  • Julen Barrenetxea Asua
    • 1
  • Saioa Leturio Fernandez
    • 3
  • Sandra Ruiz Carballo
    • 3
  • Eider Etxebarria Beitia
    • 3
  • Patricia Perez de Villarreal
    • 3
  • Lorena Hierro-Olabarria
    • 3
  • Jose Esteban Bilbao Axpe
    • 1
  • Jaime Jesus Mendez Martin
    • 3
  1. 1.Esophago-gastric Surgery and Robotic Unit, Service of General and Digestive SurgeryBasurto University HospitalBilbaoSpain
  2. 2.Esophago-gastric Surgery Unit, Service of General and Digestive SurgeryDonostia University Hospitalsan sebastianSpain
  3. 3.Service of General and Digestive SurgeryBasurto University HospitalBilbaoSpain

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