Minimally Invasive Esophagectomy for Achieving R0

Darwish, Muhammad; Nagatomo, Kei; Jackson, Terence; Cho, Edward H.; Osman, Houssam; Jeyarajah, D. Rohan

doi:10.4293/jsls.2020.00060

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…Robotic TTE was used in this patient population to further assess the robotic system’s capability to achieve tumor clearance, measured via R0 resection rates, whilst preserving the azygos vein and reducing anastomotic leakage rates. Robot-assisted MAS is associated with higher rates of R0 resection compared with conventional MAS 14 , 29 and open surgery 4 . We provide further evidence to show that R0 resection rates using robot-assisted surgery in patients requiring TTE are comparable to other surgical methods, thus demonstrating the effectiveness of this surgical system.…”

Section: Discussionmentioning

confidence: 96%

“…Compared to open surgery, minimal access surgery (MAS) can minimize intra-operative blood loss, post-operative pneumonia, length of hospital stay, and improve 1-year survival rates in patients requiring esophagectomy 1 , 2 . Aiming to reduce invasiveness and morbidity, MAS has been implemented worldwide and is often preferable to open esophagectomy 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of transthoracic esophagectomy with a next-generation surgical robot

Puntambekar¹,

Bharambe²,

Pawar³

et al. 2022

Sci Rep

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Robot-assisted minimal access surgery (MAS), compared with conventional MAS, has shown a number of benefits across several therapeutic indications but its use for transthoracic esophagectomy (TTE) requires further evaluation. Here, we report the first-in-human series of major esophageal resections performed using a next-generation tele-operated robotic surgical system in a single center. Robot-assisted TTE was performed using the Versius Surgical System by a single surgeon to assess the robotic system’s ability to achieve tumor clearance (measured by R0 resection rates) whilst reducing anastomotic leakage rates. Intra- and post-operative outcomes such as median operative time, length of hospitalization, intra-operative blood loss, and the number of complications were also assessed. Fifty-seven patients underwent robot-assisted TTE between August 2019 and June 2021. All procedures were completed successfully with no unplanned conversions to alternative surgical methods. Estimated blood loss was minimal, and no adverse events, complications or deaths were reported. Our experience with the Versius Surgical System demonstrates its safe adoption and implementation for TTE.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Feasibility of transthoracic esophagectomy with a next-generation surgical robot

Puntambekar¹,

Bharambe²,

Pawar³

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Although minimally invasive esophagectomy is reportedly less invasive than open esophagectomy with respect to perioperative and postoperative outcomes, especially for maintenance of long-term respiratory function, [7][8][9][10] anastomotic leakage may lead to severe intrathoracic infections, including mediastinitis. The following 3 aspects of our technique were designed as a countermeasure to this concern: (1) a linear stapler was used for all anastomotic procedures, from esophagogastric anastomosis to entry hole closure; (2) the pleura was closed to separate the esophagogastric anastomotic site from the thoracic cavity and to prevent deflection of the gastric tube in the right pleural cavity; and (3) the mediastinal drain was inserted transhiatally from the abdominal cavity.…”

Section: Discussionmentioning

confidence: 99%

A Novel Method for Thoracoscopic Overlap Esophagogastric Reconstruction With Pleural Closure following Minimally Invasive Ivor-Lewis Esophagectomy for Esophagogastric Junction Cancer

Sano,

Sohda,

Hosoi

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Intrathoracic esophagogastric anastomosis following minimally invasive Ivor-Lewis esophagectomy is a technically demanding surgical technique that can result in serious intrathoracic infections when anastomotic leakage occurs. Herein, we report a novel side-overlap esophagogastric anastomosis with pleural closure for esophagogastric junction cancer. Methods: The 3 key points of our novel technique were the following: (1) overlap esophagogastric anastomosis and closure of the entry hole were all performed using a linear stapler; (2) the pleura was closed to separate the anastomotic site from the thoracic cavity; and (3) the mediastinal drain was inserted transhiatally from the abdominal cavity. Results: This modified anastomosis procedure was performed on 8 consecutive patients at our institution. The median overall/thoracoscopic operating time and estimated blood loss were 652.5/241.5 min and 89 mL, respectively. No mortality or serious postoperative complications occurred, and the median postoperative hospital stay was 22 days (range, 17 to 37 d). Conclusion: This novel thoracoscopic overlap esophagogastric reconstruction procedure with pleural closure is safe and feasible.

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“…Some studies show an improvement in perioperative morbidity with MIE compared to OE [ 30 , 31 ]. Offering octogenarians an MIE can decrease their post-operative morbidity and improve their oncologic outcomes including resection margin status [ 32 ].…”

Section: Discussionmentioning

confidence: 99%