0000000000267125
AUTHOR
Jelle P Ruurda
Hybrid minimally invasive esophagectomy for esophageal cancer : less is more
In a recently published multi-center randomized controlled trial ( New England Journal of Medicine 2019;380:152-162) Christophe Mariette and colleagues compared open transthoracic esophagectomy to hybrid esophagectomy (open thoracic phase, laparoscopic abdominal phase) for patients with resectable cancer of the middle or lower third of the esophagus (MIRO trial) (1).
Technical details of the hand-sewn and circular-stapled anastomosis in robot-assisted minimally invasive esophagectomy.
SUMMARY The circular mechanical and hand-sewn intrathoracic anastomosis are most often used in robot-assisted minimally invasive esophagectomy (RAMIE). The aim of this study was to describe the technical details of both techniques that were pioneered in two high volume centers for RAMIE. A prospectively maintained database was used to identify patients with esophageal cancer who underwent RAMIE with intrathoracic anastomosis. The primary outcome was anastomotic leakage, which was analyzed using a moving average curve. For the hand-sewn anastomosis, video recordings were reviewed to evaluate number of sutures and distances between the anastomosis and the longitudinal staple line or gastric c…
The da Vinci Xi Robotic Four-Arm Approach for Robotic-Assisted Minimally Invasive Esophagectomy
AbstractRobotic surgery is gaining importance in complex thoracoscopic surgery, such as robotic-assisted minimally invasive esophagectomy (RAMIE). The RAMIE procedure was designed using the first generation of the robotic system. The latest da Vinci Xi system has substantially increased the dexterity, especially designed for multiquadrant surgery. The original three-arm RAMIE approach was modified including the robotic four-arm use for the thoracoscopic and laparoscopic part of the operation. This extended approach (four-arm RAMIE approach) provides more flexibility and raises the independence of the surgeon.