280. FEASIBILITY OF ROBOTIC-ASSISTED SURGERY FOR BENIGN ESOPHAGEAL LESIONS: SINGLE-CENTER EXPERIENCE

Abstract

Abstract Background Benign esophageal lesions are uncommon conditions compared to malignant cases. Thoracotomy is an extremely invasive procedure that can cause severe complications and delay recovery. Conventional VATS is limited in its approach to deep and narrow angles and difficult to manipulate due to abundance of vital structures that are always mobile in mediastinal area. Robotic-assisted surgery is a new challenge that aims to achieve minimally invasive procedures and improve postoperative outcomes for benign esophageal lesions. Methods We conducted a retrospective analysis of a single-center database from May 2012 to November 2022, including patients aged 20–75 years with diagnosed benign esophageal lesions such as esophageal leiomyoma and esophageal diverticulum who underwent robotic-assisted esophageal surgery using the Da Vinci Robotic surgery system. The operation was performed using either a transthoracic or transabdominal approach. Patient data, surgical procedures, interventions, and early outcomes (within 30 days post-operation) were collected and analyzed to assess postoperative variables. The study included 13 patients, and the primary outcome was the incidence of pulmonary complications during the hospital stay. Results The number of patients with each esophageal lesion was as follows: esophageal leiomyoma, 6 cases (46.1%); esophageal diverticulum, 3 cases (23.1%); and other benign lesions, 4 cases (30.8%). Robotics approaches were divided into 11 cases (84.6%) and 2 cases (15.4%) for transthoracic and transabdominal, respectively. The overall incidence of postoperative pulmonary complications was 5 cases (38.5%), with mild pulmonary infection occurred in 2 cases (15.4%). Other pulmonary complications occurred in the transthoracic approach due to patient characteristics related to underlying lung diseases, such as COPD and asthma. There was no evidence of 30 days mortality in our series. Conclusion Robotic-assisted surgery is feasible for benign esophageal surgery using both transthoracic and transabdominal approaches. Robotic devices can provide stabilization for both 3D camera views and instrument arms, particularly enhancing suturing ability. Robotic surgery is precise and maneuverable, with potential to perform intricate surgical procedures in tight angles and confined spaces such as the thoracic cavity and hiatal area. These factors can improve the overall operative outcome and enhance recovery due to minimally invasive access.