Preservation of replaced left hepatic artery during robotic-assisted minimally invasive esophagectomy: A case series

2017 ◽  
Vol 13 (4) ◽  
pp. e1802 ◽  
Author(s):  
Nicholas R. Hess ◽  
Nabil P. Rizk ◽  
James D. Luketich ◽  
Inderpal S. Sarkaria
Keyword(s):  
Minimally Invasive ◽  
Hepatic Artery ◽  
Minimally Invasive Esophagectomy ◽  
Case Series ◽  
Left Hepatic Artery ◽  
Robotic Assisted ◽  
Invasive Esophagectomy

scholarly journals Preservation of replaced left hepatic artery during 3D laparoscopic totally minimally invasive esophagectomy for cancer

2019 ◽  
Vol 7 (9) ◽  
pp. 1787-1788
Author(s):  
Athanasios Syllaios ◽  
Spyridon Davakis ◽  
Elias Sdralis ◽  
Stamatios Petousis ◽  
Bruno Lorenzi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hepatic Artery ◽  
Minimally Invasive Esophagectomy ◽  
Left Hepatic Artery ◽  
Invasive Esophagectomy ◽  
Esophagectomy For Cancer

scholarly journals Robotic assisted minimally invasive esophagectomy: Ivor-Lewis approach

2021 ◽  
Vol 5 ◽  
pp. 21-21
Author(s):  
Kelsey Musgrove ◽  
Charlotte R. Spear ◽  
Jahnavi Kakuturu ◽  
Britney R. Harris ◽  
Fazil Abbas ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Ivor Lewis ◽  
Robotic Assisted ◽  
Invasive Esophagectomy

PS02.250: PREEMPTIVE ENDOSCOPIC VACUUM DRAINAGE TO PREVENT ANASTOMOTIC LEAKAGE IN UPPER-GI SURGERY: A GAME-CHANGING TECHNOLOGY?

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 194-194
Author(s):  
Henner M Schmidt ◽  
Diana Vetter ◽  
Christoph Gubler ◽  
Piero Valli ◽  
Bernhard Morell ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Conflicts Of Interest ◽  
Minimally Invasive Esophagectomy ◽  
Case Series ◽  
Gastric Surgery ◽  
Safe Procedure ◽  
Comprehensive Complication Index ◽  
Invasive Esophagectomy ◽  
Upper Gi ◽  
Primary Endpoints

Abstract Background Anastomotic leak (AL) remains a major cause of morbidity in upper-GI surgery. In many centers, endoluminal vacuum drainage (EVD) has become the mainstay of therapy for AL after esophageal and gastric resections. A new idea is to use the EVD technology in a preemptive setting. In this context, we present a case series of patients that received PEVD upon completion of the anastomosis during esophago-gastric surgery. Methods Intraoperative PEVD was performed in 10 consecutive patients undergoing minimally invasive esophagectomy with cervical (n = 1) or high intrathoracic (n = 6) anastomosis, and open transhiatally extended (n = 1) or minimally invasive (n = 2) total gastrectomy. The EVD device was removed after three to six (mean 4) days, and the anastomosis was endoscopically inspected for ischemia and AL. Additional contrast radiography, computed tomography, or gastroscopy to exclude AL was performed in seven patients. Primary endpoints in this retrospective series was AL; secondary endpoints were the postoperative morbidity measured by the Clavien-Dindo (CD) classification and the comprehensive complication index (CCI), all at 30 days after surgery. Results Perioperative mortality was 0% with uneventful anastomotic healing in all patients of this series (AL rate 0%, anastomotic stenosis 0%). There were no adverse events attributable to PEVD. None of the patients experienced major morbidity (> CD grade IIIa) during the postoperative course. The median postoperative ICU and hospital stay was 1 (IQR 1-1.75) and 14 (IQR 12-16) days, respectively. Five patients (50%) developed at least one complication, mostly related to infection (2 patients) and pulmonary events (2 patients). The mean CCI at 30 days after surgery was 13.7 (range 0-39.5). Conclusion PEVD appears to be a safe procedure that may emerge as a groundbreaking technology in patients undergoing esophageal or gastric resection. Further research is needed to elucidate the true potential of this technique. Disclosure All authors have declared no conflicts of interest.

O100 WORLDWIDE TECHNIQUES AND OUTCOMES OF ROBOT-ASSISTED MINIMALLY INVASIVE ESOPHAGECTOMY (RAMIE): RESULTS FROM THE INTERNATIONAL UGIRA REGISTRY

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
B F Kingma ◽  
P P Grimminger ◽  
M J van Det ◽  
Y K Chao ◽  
P Chiu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Operating Time ◽  
Case Series ◽  
Radical Resection ◽  
Pulmonary Complications ◽  
Cardiac Complications ◽  
Robot Assisted ◽  
Invasive Esophagectomy ◽  
The Mean

Abstract Aim The aim of this study was to gain insight in the techniques and outcomes of RAMIE worldwide. Background & Methods Although robot-assisted minimally invasive esophagectomy (RAMIE) is increasingly adopted. The current literature on RAMIE mainly consists of single-center case series with considerable variation in reported techniques and outcomes. To gain an overview of the worldwide practice in RAMIE, an online registry was established by the Upper GI International Robotic Association (UGIRA). The collected data involve patient- and treatment characteristics, as well as postoperative outcomes that include complications as defined by the Esophageal Complications Consensus Group, length of stay, re-admissions (i.e. <30 days after discharge), mortality (i.e. in-hospital or <30 days after surgery), and pathological results. The outcomes were descriptively analyzed for this interim report. Results A total of 434 patients who underwent RAMIE for esophageal cancer between 2016-2019 were included in this interim analysis. The mean age was 63 years (SD ±9.7), the majority was male (n=359, 83%), and nearly all patients had an ASA score ≥2 (n=398, 92%). Adenocarcinoma (n=253, 58%) and squamous cell carcinoma (n=162, 37%) were most prevalent. The usual surgical approach was transthoracic (n=428, 99%) with the patient in semiprone position (n=393, 91%). Gastric conduit reconstruction was performed in all except one patient, who received a colonic interposition. The anastomosis was created by hand-sewing (n=207, 48%), circular stapling (n=142, 32%), or linear stapling (n=85, 20%). The median intraoperative blood loss was 120 milliliters (IQR 70-280) and the median operating time was 392 minutes (IQR 353-455). Postoperative complications occurred in 251 patients (59%) and mainly involved pulmonary complications (n=138, 32%), anastomotic leakage (n=80, 18%), and cardiac complications (n=55, 13%). Mortality occurred in 9 patients (2%) and re-admission because of complications was required in 57 patients (14%). A median of 28 lymph nodes (IQR 21-35) were removed and a radical resection was achieved in 400 patients (92%). Conclusion The presented results are the first to provide an overview of the techniques that are commonly used in RAMIE. By demonstrating results that are in line with recent benchmarking literature, this study demonstrates the safety and feasibility of RAMIE.

scholarly journals Robotic-assisted minimally invasive esophagectomy: past, present and future

2020 ◽  
Vol 12 (2) ◽  
pp. 54-62 ◽  
Author(s):  
Gijsbert I. van Boxel ◽  
B. Feike Kingma ◽  
Frank J. Voskens ◽  
Jelle P. Ruurda ◽  
Richard van Hillegersberg
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Robotic Assisted ◽  
Invasive Esophagectomy

Robotic-Assisted Minimally Invasive Esophagectomy

2014 ◽  
Vol 24 (2) ◽  
pp. 211-222 ◽  
Author(s):  
Inderpal S. Sarkaria ◽  
Nabil P. Rizk
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Robotic Assisted ◽  
Invasive Esophagectomy

scholarly journals Attaining Proficiency in Robotic-Assisted Minimally Invasive Esophagectomy While Maximizing Safety during Procedure Development

2016 ◽  
Vol 11 (4) ◽  
pp. 268-273 ◽  
Author(s):  
Inderpal S. Sarkaria ◽  
Nabil P. Rizk ◽  
Rachel Grosser ◽  
Debra Goldman ◽  
David J. Finley ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Operative Time ◽  
Minimally Invasive Esophagectomy ◽  
Intraoperative Complications ◽  
Team Approach ◽  
Robotic Assisted ◽  
Invasive Esophagectomy ◽  
Estimated Blood Loss ◽  
Dedicated Team ◽  
Median Operative Time

Objective Robotic-assisted minimally invasive esophagectomy (RAMIE) is an emerging complex operation with limited reports detailing morbidity, mortality, and requirements for attaining proficiency. Our objective was to develop a standardized RAMIE technique, evaluate procedure safety, and assess outcomes using a dedicated operative team and 2-surgeon approach. Methods We conducted a study of sequential patients undergoing RAMIE from January 25, 2011, to May 5, 2014. Intermedian demographics and perioperative data were compared between sequential halves of the experience using the Wilcoxon rank sum test and the Fischer exact test. Median operative time was tracked over successive 15-patient cohorts. Results One hundred of 313 esophageal resections performed at our institution underwent RAMIE during the study period. A dedicated team including 2 attending surgeons and uniform anesthesia and OR staff was established. There were no significant differences in age, sex, histology, stage, induction therapy, or risk class between the 2 halves of the study. Estimated blood loss, conversions, operative times, and overall complications significantly decreased. The median resected lymph nodes increased but was not statistically significant. Median operative time decreased to approximately 370 minutes between the 30th and the 45th cases. There were no emergent intraoperative complications, and the anastomotic leak rate was 6% (6/100). The 30-day mortality was 0% (0/100), and the 90-day mortality was 1% (1/100). Conclusions Excellent perioperative and short-term patient outcomes with minimal mortality can be achieved using a standardized RAMIE procedure and a dedicated team approach. The structured process described may serve as a model to maximize patients’ safety during development and assessment of complex novel procedures.

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