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Surgical Endoscopy
Published in: Surgical Endoscopy 9/2006

01-09-2006

First experience with robot-assisted thoracoscopic esophagolymphadenectomy for esophageal cancer

Authors: R. van Hillegersberg, J. Boone, W. A. Draaisma, I. A. M. J. Broeders, M. J. M. M. Giezeman, I. H. M. Borel Rinkes

Published in: Surgical Endoscopy | Issue 9/2006

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Abstract

Background

Transthoracic esophagectomy with extended lymph node dissection is associated with higher morbidity rates than transhiatal esophagectomy. This morbidity rate could be reduced by the use of minimally invasive techniques. The feasibility of robot-assisted thoracoscopic esophagectomy (RTE) with mediastinal lymphadenectomy was assessed prospectively.

Methods

This study investigated 21 consecutive patients with esophageal cancer who underwent RTE using the Da Vinci™ robotic system. Continuity was restored with a gastric conduit and a cervical anastomosis.

Results

A total of 18 (86%) procedures were completed thoracoscopically. The operating time for the thoracoscopic phase was 180 min (range, 120–240 min), and the median blood loss was 400 ml (range, 150–700 ml). A median of 20 (range, 9–30) lymph nodes were retrieved. The median intensive care unit stay was 4 days (range, 1–129 days), and the hospital stay was 18 days (range, 11–182 days). Pulmonary complications occurred in 10 patients (48%), and one patient (5%) died of a tracheoneoesophageal fistula.

Conclusions

In this initial experience, robot-assisted thoracoscopic esophagectomy was found to be feasible, providing an effective lymphadenectomy with low blood loss. Standardization of the technique and increased experience should reduce the complication rate, which is in the range of the rate for open transthoracic dissection.
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Metadata
Title
First experience with robot-assisted thoracoscopic esophagolymphadenectomy for esophageal cancer
Authors
R. van Hillegersberg
J. Boone
W. A. Draaisma
I. A. M. J. Broeders
M. J. M. M. Giezeman
I. H. M. Borel Rinkes
Publication date
01-09-2006
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 9/2006
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-005-0674-8

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