Application of full lateral decubitus position with cephalic parallel approach in robotic-assisted minimally invasive esophagectomy.

Abstract

To overcome the technical shortcomings of robot-assisted minimally invasive esophagectomy (RAMIE), we designed an optimized approach called full lateral position with cephalic-parallel approach for this technique. We described and demonstrated the details regarding the full lateral position with cephalic-parallel approach for mobilization of the esophagus and mediastinal lymphadenectomy. On the basis of the location and T stage of esophageal cancer, a disease-specific resection process was also designed and introduced. Ten of our latest RAMIE procedures were performed using this approach. Perioperative data were collected and analyzed. The mean duration of the entire RAMIE procedure was 381.0±57.5 min. Two (20%) patients suffered from postoperative hoarseness. The mean total number of lymph nodes dissected was 22.4±4.0, and the mean number of positive lymph nodes dissected was 2.0±2.7. The newly designed full lateral position with cephalic-parallel approach, which makes the procedure highly convenient, is technically feasible for RAMIE.