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robotic esophagectomy

Zihui Tan, Xu Zhang, Xinye Wang, Jianhua Fu
OBJECTIVE: To evaluate the feasibility, safety and short-term clinical outcomes of robot-assisted minimally invasive esophagectomy (RAMIE). METHODS: Clinical data of 17 patients with esophageal cancer who received RAMIE between April 2016 and July 2016 were analyzed retrospectively. RESULTS: The age of the patients ranged from 44 to 83. Six patients received neoadjuvant radiochemotherapy while 11 patients underwent surgery alone. All patients were performed by the robot-assisted thoraco-laparoscopic minimally invasive esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Inderpal S Sarkaria, Nabil P Rizk, Rachel Grosser, Debra Goldman, David J Finley, Amanda Ghanie, Camelia S Sima, Manjit S Bains, Prasad S Adusumilli, Valerie W Rusch, David R Jones
OBJECTIVE: Robotic-assisted minimally invasive esophagectomy (RAMIE) is an emerging complex operation with limited reports detailing morbidity, mortality, and requirements for attaining proficiency. Our objective was to develop a standardized RAMIE technique, evaluate procedure safety, and assess outcomes using a dedicated operative team and 2-surgeon approach. METHODS: We conducted a study of sequential patients undergoing RAMIE from January 25, 2011, to May 5, 2014...
July 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Robert J Cerfolio, Benjamin Wei, Mary T Hawn, Douglas J Minnich
Minimally invasive esophagectomy with intrathoracic dissection and anastomosis is increasingly performed. Our objectives are to report our operative technique, early results and lessons learned. This is a retrospective review of 85 consecutive patients who were scheduled for minimally invasive Ivor Lewis esophagectomy (laparoscopic or robotic abdominal and robotic chest) for esophageal cancer. Between 4/2011 and 3/2015, 85 (74 men, median age: 63) patients underwent robotic Ivor Lewis esophageal resection. In all, 64 patients (75%) had preoperative chemoradiotherapy, 99% had esophageal cancer, and 99% had an R0 resection...
2016: Seminars in Thoracic and Cardiovascular Surgery
Zane Hammoud
Robotic-assisted minimally invasive esophagectomy is gaining acceptance as a safe and effective alternative to open esophagectomy.
2016: Seminars in Thoracic and Cardiovascular Surgery
Yassar A Qureshi, Khaled I Dawas, Muntzer Mughal, Borzoueh Mohammadi
Esophageal cancer has a poor prognosis, with little improvement in outcomes in recent years. Surgery maintains its pivotal role in cure, but this involves two or three compartment dissection with associated high risks. Chiefly, pulmonary complications following surgery are most common, and can be life-threatening. As a consequence, minimally invasive and robotic esophagectomy have been performed with improving efficacy and equivalent oncological outcomes. This is a review of the pertinent literature regarding these techniques...
August 19, 2016: Journal of Surgical Oncology
R van Hillegersberg, M F J Seesing, H J F Brenkman, J P Ruurda
Esophagolymphadenectomy is the cornerstone of multimodality treatment for resectable esophageal cancer. The preferred surgical approach is transthoracic, with a two-field lymph node dissection and gastric conduit reconstruction. A minimally invasive approach has been shown to reduce postoperative complications and increase quality of life. Robot-assisted minimally invasive esophagectomy (RAMIE) was developed to facilitate this complex thoracoscopic procedure. RAMIE has been shown to be safe with good oncologic results and reduced morbidity...
August 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
R van Hillegersberg, M F J Seesing, H J F Brenkman, J P Ruurda
Esophagolymphadenectomy is the cornerstone of multimodality treatment for resectable esophageal cancer. The preferred surgical approach is transthoracic, with a two-field lymph node dissection and gastric conduit reconstruction. A minimally invasive approach has been shown to reduce postoperative complications and increase quality of life. Robot-assisted minimally invasive esophagectomy (RAMIE) was developed to facilitate this complex thoracoscopic procedure. RAMIE has been shown to be safe with good oncologic results and reduced morbidity...
July 28, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Yasuyuki Seto, Kazuhiko Mori, Yukinori Yamagata, Susumu Aikou, Syuntaro Yoshimura
Robot-assisted esophagectomy for esophageal cancer began in 2003. Both of robot-assisted minimally invasive esophagectomy (RAMIE) and robot-assisted transhiatal esophagectomy (RATE) have been applied to date. Their reports show that the short term results focused on the safety and oncological aspects are equal to the conventional procedures, though the robot-assisted esophagectomy still does not spread. We have developed the new procedure, a non-transthoracic esophagectomy combining a video-assisted cervical approach for the upper mediastinum and a robot-assisted transhiatal for the middle and lower mediastinum to overcome the disadvantages of the conventional methods, e...
July 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Koichi Suda, Masaya Nakauchi, Kazuki Inaba, Yoshinori Ishida, Ichiro Uyama
Robotic surgery with the da Vinci Surgical System has been increasingly applied in a wide range of surgical specialties, especially in urology and gynecology; however, that in the field of upper GI tract has yet to be standard due to the lack of clear benefits in comparison with conventional minimally invasive surgery. We have been performing robotic gastrectomy and esophagectomy for operable patients with resectable upper GI malignancies since 2009, and demonstrated the potential advantage that use of the robot may reduce postoperative local complications including pancreatic fistula following gastrectomy and recurrent laryngeal nerve palsy after esophagectomy, even though there have been a couple of issues to be solved including longer duration of operation and higher cost...
July 12, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Danica N Giugliano, Adam C Berger, Ernest L Rosato, Francesco Palazzo
Since the introduction of minimally invasive esophagectomy 25 years ago, its use has been reported in several high volume centers. With only one published randomized control trial and five meta-analyses comparing its outcomes to open esophagectomy, available level I evidence is very limited. Available technical approaches include total minimally invasive transthoracic (Ivor Lewis or McKeown) or transhiatal esophagectomy; several hybrid options are available with one portion of the procedure completed via an open approach...
September 2016: Langenbeck's Archives of Surgery
Jan Martínek, Jun-Ichi Akiyama, Zuzana Vacková, Manuele Furnari, Edoardo Savarino, Teus J Weijs, Elen Valitova, Sylvia van der Horst, Jelle P Ruurda, Lucas Goense, George Triadafilopoulos
Exciting new developments-pharmacologic, endoscopic, and surgical-have arisen for the treatment of many esophageal diseases. Refractory gastroesophageal reflux disease presents a therapeutic challenge, and several new options have been proposed to overcome an insufficient effectiveness of proton pump inhibitors. In patients with distal esophageal spasm, drugs and endoscopic treatments are the current mainstays of the therapeutic approach. Treatment with proton pump inhibitors (or antireflux surgery) should be considered in patients with Barrett's esophagus, since a recent meta-analysis demonstrated a 71% reduction in risk of neoplastic progression...
July 8, 2016: Annals of the New York Academy of Sciences
Lucas Goense, Peter S N van Rossum, Daniela Kandioler, Jelle P Ruurda, Khean-Lee Goh, Misha D Luyer, Mark J Krasna, Richard van Hillegersberg
Esophageal cancer is the eighth most common cancer worldwide, and the incidence of esophageal carcinoma is rapidly increasing. With the advent of new staging and treatment techniques, esophageal cancer can now be managed through various strategies. A good understanding of the advances and limitations of new staging techniques and how these can guide in individualizing treatment is important to improve outcomes for esophageal cancer patients. This paper outlines the recent progress in staging and treatment of esophageal cancer, with particularly attention to endoscopic techniques for early-stage esophageal cancer, multimodality treatment for locally advanced esophageal cancer, assessment of response to neoadjuvant treatment, and the role of cervical lymph node dissection...
July 6, 2016: Annals of the New York Academy of Sciences
Babatunde A Yerokun, Zhifei Sun, Chi-Fu Jeffrey Yang, Brian C Gulack, Paul J Speicher, Mohamed A Adam, Thomas A D'Amico, Mark W Onaitis, David H Harpole, Mark F Berry, Matthew G Hartwig
BACKGROUND: The objective of this study was to evaluate outcomes of minimally invasive approaches to esophagectomy using population-level data. METHODS: Multivariable regression modeling was used to determine predictors associated with the use of minimally invasive approaches for patients in the National Cancer Data Base who underwent resection of middle and distal clinical T13N03M0 esophageal cancers from 2010 to 2012. Perioperative outcomes and 3-year survival were compared between propensity-matched groups of patients with esophageal cancer who underwent minimally invasive esophagectomy (MIE) or open esophagectomy (OE)...
August 2016: Annals of Thoracic Surgery
Jon O Wee, Carlos E Bravo-Iñiguez, Michael T Jaklitsch
BACKGROUND: Surgical resection is a critical element in the treatment of esophageal cancer. Esophagectomy is technically challenging and is associated with high morbidity and mortality rates. Efforts to reduce these rates have spurred the adoption of minimally invasive techniques. This study describes a single-institution experience of robot-assisted esophagectomy with circular end-to-end stapled anastomosis. METHODS: Between December 2013 and April 2015, a series of consecutive patients underwent robot-assisted Ivor Lewis esophagectomy with circular end-to-end anastomosis (RAILE-EEA) at a tertiary care center with curative intent...
July 2016: Annals of Thoracic Surgery
Ahmed I Salem, Matthew R Thau, Tobin J Strom, Andrea M Abbott, Nadia Saeed, Khaldoun Almhanna, Sarah E Hoffe, Ravi Shridhar, Richard C Karl, Kenneth L Meredith
The impact of body weight on outcomes after robotic-assisted esophageal surgery for cancer has not been studied. We examined the short-term operative outcomes in patients according to their body mass index following robotic-assisted Ivor-Lewis esophagectomy at a high-volume tertiary-care referral cancer center and evaluated the safety of robotic surgery in patients with an elevated body mass index. A retrospective review of all patients who underwent robotic-assisted Ivor-Lewis esophagectomy between April 2010 and June 2013 for pathologically confirmed distal esophageal cancer was conducted...
May 4, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Judith Boone, Monique G G Hobbelink, Marguerite E I Schipper, Frank P Vleggaar, Inne H M Borel Rinkes, Robbert J de Haas, Jelle P Ruurda, Richard van Hillegersberg
BACKGROUND: Omitting extensive lymph node dissection could reduce esophagectomy morbidity in patients without lymph node metastases. Sentinel node biopsy may identify abdominal or thoracic lymph node metastases, thereby differentiating treatment. Feasibility of this approach was investigated in Western European esophageal cancer patients with advanced disease, without lymph node metastases at diagnostic work-up. METHODS: The sentinel node biopsy was performed in eight esophageal cancer patients with cT1-3N0 disease...
2016: World Journal of Surgical Oncology
Hans F Fuchs, Ryan C Broderick, Cristina R Harnsberger, Francisco Alvarez Divo, Alisa M Coker, Garth R Jacobsen, Bryan J Sandler, Michael Bouvet, Santiago Horgan
BACKGROUND: Esophagectomy may lead to impairment in gastric emptying unless pyloric drainage is performed. Pyloric drainage may be technically challenging during minimally invasive esophagectomy and can add morbidity. We sought to determine the effectiveness of intraoperative endoscopic injection of botulinum toxin into the pylorus during robotic-assisted esophagectomy as an alternative to surgical pyloric drainage. MATERIALS AND METHODS: We performed a retrospective analysis of patients with adenocarcinoma and squamous cell carcinoma of the distal esophagus or gastroesophageal junction who underwent robotic-assisted transhiatal esophagectomy (RATE) without any surgical pyloric drainage...
June 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ravi Shridhar, Andrea M Abbott, Matthew Doepker, Sarah E Hoffe, Khaldoun Almhanna, Kenneth L Meredith
BACKGROUND: Neoadjuvant chemoradiotherapy (NCR) for the treatment of esophageal cancer has been associated with increased perioperative morbidity and mortality. Minimally invasive procedures utilizing robotic techniques have been shown to reduce perioperative complications and length of hospitalization (LOH). The purpose of this study is to compare perioperative outcomes between patients undergoing NCR and robotic-assisted Ivor Lewis esophagectomy (RAIL) versus upfront RAIL. METHODS: A database of esophagectomy patients was queried to identify RAIL patients...
April 2016: Journal of Gastrointestinal Oncology
Eugenio Pompeo
In Italy there exists quite a long and rich history in minimally invasive thoracic surgery. Pioneer Italian surgeons have been amongst those who first adopted video-assisted thoracic surgery (VATS) to perform procedures such as lobectomy and esophagectomy, respectively and quite many others have provided important contributions related to minimally invasive thoracic surgery and have proposed innovative ideas and creative technical refinements. According to a web search on recent studies published in Italy on minimally invasive thoracic surgery along the last 3 years, uniportal, nonintubated, and robotic VATS as well as VATS lobectomy have been found to represent the most frequently investigated issues...
October 2015: Annals of Translational Medicine
Stefano Bongiolatti, Mario Annecchiarico, Michele Di Marino, Bernardo Boffi, Sara Borgianni, Alessandro Gonfiotti, Luca Voltolini, Andrea Coratti
INTRODUCTION: Robot-assisted minimally invasive esophagectomy with intra-thoracic anastomosis showed encouraging results but there is a lack of data to demonstrate the safety and feasibility. OBJECTIVE: The aim of this study is to report our experience in RA-ILE (robotic-assisted Ivor-Lewis esophagectomy) with robotic hand-sewn anastomosis. METHODS: This is a retrospective study of patients who underwent robotic-assisted esophagectomy in prone position with intrathoracic anastomosis for malignant neoplasm of the esophagus or esophago-gastric junction...
September 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
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