Robot-Assisted McKeown Esophagectomy

Abstract

Three-hole esophagectomy or McKeown esophagectomy can be performed using the robot. We reserve this approach for patients with a mid esophageal tumor where the anastomosis in the neck allows complete resection of the tumor with negative surgical margins. Typically, patients with locally advanced esophageal cancer undergo induction chemoradiation therapy. Afterward, the patient undergoes restaging with PET-CT and EUS. Patients with concern for the invasion of the airway on the imaging or on EUS, they undergo flexible bronchoscopy with EBUS to ensure there is no invasion of the trachea. Patients also undergo a cardiac and pulmonary evaluation to ensure that patient is a good candidate for surgical treatment.