Mastering minimally invasive esophagectomy requires a mentor; experience of a personal mentorship

Cuesta, Miguel A.; Wielen, Nicole van der; Straatman, Jennifer; Peet, Donald L. van der

doi:10.1016/j.amsu.2016.12.050

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…To accomplish this surgical teaching program, a mentorship seems the most ideal method to teach the apprentice surgeon these specific skills. A pioneering teaching program for a minimally invasive esophagectomy for esophageal cancer was started in 2009 [ 38 ]. As part of the mentoring cancer institutes throughout Europe, the Hospital General Universitario Gregorio Marañon (Madrid, Spain) explored the feasibility of integrating of intraoperative electron irradiation while the mentoring process in the Surgical Department by Prof. Cuesta as part of the innovation launched for esophageal cancer patients requiring multimodal therapy for locally advanced cancer stages [ 31 ] (Fig.…”

Section: Discussionmentioning

confidence: 99%

Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development

et al. 2022

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Background Local cancer therapy by combining real-time surgical exploration and resection with delivery of a single dose of high-energy electron irradiation entails a very precise and effective local therapeutic approach. Integrating the benefits from minimally invasive surgical techniques with the very precise delivery of intraoperative electron irradiation results in an efficient combined modality therapy. Methods Patients with locally advanced disease, who are candidates for laparoscopic and/or thoracoscopic surgery, received an integrated multimodal management. Preoperative treatment included induction chemotherapy and/or chemoradiation, followed by laparoscopic surgery and intraoperative electron radiation therapy. Results In a period of 5 consecutive years, 125 rectal cancer patients were treated, of which 35% underwent a laparoscopic approach. We found no differences in cancer outcomes and tolerance between the open and laparoscopic groups. Two esophageal cancer patients were treated with IOeRT during thoracoscopic resection, with the resection specimens showing intense downstaging effects. Two oligo-recurrent prostatic cancer patients (isolated nodal progression) had a robotic-assisted surgical resection and post-lymphadenectomy electron boost on the vascular and lateral pelvic wall. Conclusions Minimally invasive and robotic-assisted surgery is feasible to combine with intraoperative electron radiation therapy and offers a new model explored with electron-FLASH beams.

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Section: Discussionmentioning

confidence: 99%

Clinical feasibility of combining intraoperative electron radiation therapy with minimally invasive surgery: a potential for electron-FLASH clinical development

et al. 2022

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“…The minimally invasive approach requires mandatory experience in open esophageal surgery (which is difficult to obtain), advanced skills in endoscopic surgery, and the supervision of the first operations by an experienced mentor (7). The duration of surgery, the morbidity and mortality associated with the procedure and the long learning curve (at least 35 operations) may initially be important obstacles in implementing the minimally invasive approach (8).…”

Section: Introductionmentioning

confidence: 99%

Recent Advances in Minimally Invasive Esophagectomy

Achim¹,

Constantinoiu²

2018

chr

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The treatment of esophageal cancer has become more effective due to advances in surgical techniques, multidisciplinary approach, appropriate use of neoadjuvant therapy and perioperative care at centers of excellence in esophageal surgery. Esophagectomy is one of the most complicated and demanding procedures among all gastrointestinal surgeries with a very long learning curve in which excellence can only be achieved through improvement during all the surgical career. The results of esophagectomy are related not only to the volume of cases operated but also to the experience of surgeons in the management of postoperative complications. Initially, minimally invasive esophagectomy has encountered obstacles to implementation in several centers due to the cost and complexity of esophageal cancer treatment. Several meta-analyses and clinical trials published so far support the feasibility of the minimally invasive approach, the advantages of the post-operative period and the equivalence of oncological outcomes with the open technique, which is an important step in imposing minimally invasive techniques as a standard in the treatment of esophageal cancer. In this paper, we aim to analyze recent advances in minimally invasive esophagectomy, the evolution of endoscopic surgical techniques through our personal experience and the results of studies published in the medical literature in the last years.

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