Abstract
In recent years, the evolution of advanced robotic medical systems has increased rapidly. These technical developments have led to advanced robotic systems, such as the da Vinci Xi, which allows superior controlled complex procedures and innovative surgical strategies. In esophageal surgery, the robotic-assisted minimally invasive esophagectomy (RAMIE) procedure is being developed and carried out with increasing frequency at centers worldwide. Recently, a new single port robotic system was introduced (da Vinci Single Port (SP)), which may allow for the exploration of new routes, such as transcervical robotic assisted minimally invasive esophagectomy (TC-RAMIE). This approach avoids opening the pleura by entering the mediastinum through the jugular window. In this report, we describe the technical steps of the TC-RAMIE using the new da Vinci SP system and compare it to the da Vinci Xi system.
Highlights
Most common robotic assisted procedures for esophageal surgery use either transhiatal or transthoracic approaches
The development of robotic systems, such as the da Vinci Xi and the new da Vinci Single Port (SP) (Intuitive Surgical Inc., Sunnyvale, CA, USA), has allowed for controlled transcervical extrapleural mediastinoscopic access, which may be a feasible approach for a certain group of patients
The da Vinci SP system allowed dissection of the the the esophagus until the hiatal crus was reached without interference of the instrumentation in two esophagus until the hiatal crus was reached without interference of the instrumentation in esophagus until the hiatal crus was reached without interference of the instrumentation in two cadavers
Summary
Most common robotic assisted procedures for esophageal surgery use either transhiatal or transthoracic approaches. The cervical access is commonly performed as open surgery when a cervical anastomosis or a three field lymphadenectomy is indicated. The cervical mediastinoscopic approach is not commonly used in minimally invasive esophageal surgery. The development of robotic systems, such as the da Vinci Xi and the new da Vinci Single Port (SP) (Intuitive Surgical Inc., Sunnyvale, CA, USA), has allowed for controlled transcervical extrapleural mediastinoscopic access, which may be a feasible approach for a certain group of patients. Potential clinical benefits include the avoidance of single lung ventilation, as well as the postoperative development of pneumonia, which is one of the most common morbidities after transthoracic esophageal surgery.
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