Trends in the evolution to robot-assisted minimally invasive thoracoscopic esophagectomy

Jiajia Liu,Kazuhiro Imai,Yusuke Sato,Akiyuki Wakita,Hiromu Fujita,Yushi Nagaki,Yoshihiro Minamiya,Yuta Kawakita,Satoru Motoyama

doi:10.20517/2574-1225.2020.20

Abstract

Much effort has been made to improve outcomes and/or minimize the invasiveness of esophagectomy for thoracic esophageal cancer. This has led to the evolution from open esophagectomy to thoracoscopic minimally invasive esophagectomy (MIE), and from MIE to robot-assisted minimally invasive esophagectomy (RAMIE). RAMIE is being applied clinically to overcome the limitations of MIE. In this article, we review the trends in the evolution from thoracoscopic MIE to RAMIE. It has now been demonstrated that RAMIE is both safe and feasible, and may decrease morbidity and mortality rates associated with esophagectomy and improve oncological outcomes. On the other hand, there are still many problems that need to be solved.

Highlights

Esophageal cancer is the 6th highest cause of cancer mortality worldwide due, in large part, to its high potential for metastasis[1]
We review the trends in the evolution from thoracoscopic esophagectomy to minimally invasive esophagectomy (MIE) and robot-assisted minimally invasive esophagectomy (RAMIE)
RAMIE was associated with less intraoperative blood loss, lower postoperative pain scores, faster functional recovery, and better quality of life when compared to open esophagectomy (OE)[31]

Summary

INTRODUCTION

Esophageal cancer is the 6th highest cause of cancer mortality worldwide due, in large part, to its high potential for metastasis[1]. Grimminger et al.[28] reported a series of 75 patients (HMIE 25, total MIE 25, RAMIE 25), which showed comparable morbidity and short-term outcomes in the three groups, the total minimally invasive approaches appear to be associated with a lower incidence of complications such as pneumonia and wound infections. Those studies showed that HMIE is a transitional operative method between OE and total MIE, because of its relatively lower difficulty level, somewhat reduced invasiveness and satisfactory clinical outcomes, it is a valuable operative method worth being performed.

Limitations