Robot‐sewn Ivor‐Lewis anastomosis: preliminary experience and technical details

Abstract

This preliminary experience suggests that robotic-assisted RA-ILE for malignant lesions is a real surgical option compared with conventional surgery with satisfactory results. Copyright © 2015 John Wiley & Sons, Ltd.

Early experience with totally robotic esophagectomy for malignancy. Surgical and oncological outcomes

“…The introduction of multimodal therapy and especially neoadjuvant chemoradiotherapy (CRT) has considerably improved the outcomes of patients with esophageal malignancy during recent decades . Substantive changes have also been introduced in surgical practice, with the aim of offering a less invasive procedure while ensuring oncological radicality and expected survival . Indeed, although esophagectomy was originally considered a relative contraindication to the application of minimally invasive surgery (MIS), in recent years laparoscopy/thoracoscopy has progressively gained popularity, substantially due to favorable perioperative outcomes .…”

“…Indeed, although esophagectomy was originally considered a relative contraindication to the application of minimally invasive surgery (MIS), in recent years laparoscopy/thoracoscopy has progressively gained popularity, substantially due to favorable perioperative outcomes . Moreover, several concerns regarding oncological adequacy have now been allayed …”

Minimally invasive and robotic esophagectomy: state of the art

“…In RAMIE, the utilization of EndoWrist instruments, the deeper high definition 3D vision, the motion scaling and tremor filtration make a hand-sewn intrathoracic anastomosis possible and easier to accomplish. Trugeda and more recently Bongiolatti (40,41), published personal series of RAILE with hand-sewn intrathoracic esophagogastric anastomosis without increased incidence of leakage, stenosis or prolonged operative time. A published survey by Haverkamp et al (20) shows that nowadays the preferred technique of anastomosis is to stapler the thoracic anastomosis and to hand-sew the cervical ones.…”

Robot-assisted Ivor-Lewis esophagectomy with intrathoracic robot-sewn anastomosis

“…As a result, the Ivor-Lewis technique is increasingly being used especially for middle and lower esophageal cancer (12). RA-ILE was developed later than the McKeown approach, because of the greater complexity of performing a minimally invasive intra-thoracic anastomosis using stapler devices, as the insertion and correct positioning of staplers into the chest is very difficult and restricted by the rigidity of ICSs (13).…”