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robotic esophagectomy

I Gockel, D Lorenz
Minimally invasive resections are increasingly employed in oncologic surgery for esophageal carcinoma. The new German S3 guideline states that esophagectomy, as well as reconstruction of the esophagus, can be performed minimally invasively or in combination with open techniques (hybrid). However, the current value of different techniques - ranging from complete minimally invasive esophagectomy over hybrid to robotic surgery - remains unregarded.This review provides a critical comparison of these techniques based on current evidence...
January 5, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Seong Yong Park, Dae Joon Kim, Young Woo Do, Jeewon Suh, Seokkee Lee
BACKGROUND: The oncologic outcome of esophageal squamous cell carcinoma (ESCC) patients after robot-assisted thoracoscopic esophagectomy (RATE) with total mediastinal lymphadenectomy (ML) has not been reported. This study was performed to determine the oncologic outcome of RATE and the effectiveness of total ML for ESCC. METHODS: The 115 patients who underwent RATE without neoadjuvant therapy from 2006 to 2014 were reviewed. The efficacy index (EI) was calculated by multiplying the incidence of metastasis by the 3-year survival rate of the patients for each node station...
December 6, 2016: Annals of Thoracic Surgery
Qi-Xin Shang, Long-Qi Chen, Wei-Peng Hu, Han-Yu Deng, Yong Yuan, Jie Cai
There are many controversies in lymphadenectomy for thoracic esophageal cancer, and whether 3-field lymphadenectomy or 2-field lymphadenectomy is better have still been in doubt. The aim of this article is to review the role of the lymph node dissection by introducing the merits and demerits in 3-field lymphadenectomy, and the development in lymphadenectomy's selection, treatment and diagnosis. All the literatures related to esophageal lymphadenectomy and minimally invasive surgery (MIE) were searched in PubMed database and the cross references were added and reviewed to complete the reference list...
October 2016: Journal of Thoracic Disease
Samina Park, Yoohwa Hwang, Hyun Joo Lee, In Kyu Park, Young Tae Kim, Chang Hyun Kang
BACKGROUND: The aim of the study was to compare robot-assisted esophagectomy (RE) with thoracoscopic esophagectomy (TE) for the treatment of esophageal squamous cell carcinoma (ESCC). METHODS: A total of 105 patients who underwent RE (n=62) or TE (n=43) due to ESCC were included in this study. Early postoperative outcomes and long-term survivals between the two groups were compared. RESULTS: The RE and TE groups were comparable in preoperative clinical characteristics...
October 2016: Journal of Thoracic Disease
Dae Myoung Jeong, Jie Ae Kim, Hyun Joo Ahn, Mikyung Yang, Burn Young Heo, Soo Hee Lee
BACKGROUND: Postoperative delirium (POD) is one of messy complications related with increased mortality and hospital costs. Patients undergoing esophagectomy are more in danger of delirium than other kinds of surgeries. We investigated the impact of robot-assisted thoracoscopic esophagectomy on the incidence of POD compared with open transthoracic esophagectomy. MATERIALS AND METHODS: A retrospective review was completed for the patients who underwent esophagectomy from December 2, 2012 and April 15, 2015 (n=529)...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
J Kirchberg, T Mees, J Weitz
In the last few years robotic surgery has progressed from being confined to a small niche to a widespread application in routine visceral surgery; however, evidence for superiority of robotic surgery compared to laparoscopy from randomized studies with a sufficient number of patients is still lacking in most fields of visceral surgery. For complex operations that necessitate an extensive reconstruction phase, such as pancreatectomy, gastrectomy and esophagectomy, there is a potential benefit for the permanent and justified use of robotic surgery...
December 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Ran B Luo, Domingo Montalvo, Toshiaki Suzuki, Bryan J Sandler, Garth R Jacobsen, Santiago Horgan
INTRODUCTION: Laparoscopic foregut surgeries are highly complex procedures that carry a high potential for morbidity and mortality should complications should occur. The robotic-assisted platform offers improved visualization of anatomy, optimal fine motor control, and a higher degree of instrumentation range of motion, which may potentially lead to better outcomes. This paper reviews the risks and benefits of the robotic platform in foregut procedures. EVIDENCE ACQUISITION: A web-based literature search was performed, in August 2016 using Pubmed, EMBASE, and Google Scholar from cited English publications from 1996 to 2016...
October 27, 2016: Minerva Chirurgica
Philip W Chiu, Anthony Y Teoh, Vivien W Wong, Hon Chi Yip, Shannon M Chan, Simon K Wong, Enders K Ng
Minimally invasive esophagectomy (MIE) is technically challenging. Da Vinci Robotic system could improve surgical dissection with additional degree of freedom from robotic arms. This study aimed to assess the feasibility and safety of performing MIE using Da Vinci Robotic system among patients with esophageal cancers. From 2009 to 2013, consecutive patients with esophageal cancers who received robotic-assisted MIE were recruited. We excluded tumors with suspected invasion to adjacent organs. Preoperative staging included EUS, CT thorax and abdomen and bronchoscopy...
October 25, 2016: Journal of Robotic Surgery
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...
November 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, in the field of upper gastrointestinal (GI) tract, the da Vinci Surgical System has yet to be standard as a result of a lack of clear benefits in comparison with conventional minimally invasive surgery. We have been carrying out robotic gastrectomy and esophagectomy for operable patients with resectable upper GI malignancies since 2009, and have demonstrated the potential advantages of the use of the robot in possibly reducing postoperative local complications including pancreatic fistula following gastrectomy and recurrent laryngeal nerve palsy after esophagectomy, even though there have been a couple of problems to be solved including longer duration of operation and higher cost...
November 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...
October 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
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