VS01.08: STEPWISE APPROACH FOR ROBOT-ASSISTED THORACOSCOPIC LEFT RECURRENT LARYNGEAL NERVE LYMPH NODE DISSECTION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 45-45
Author(s):  
Yin-Kai Chao
Keyword(s):  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Lymph Node Dissection ◽  
Dorsal Side ◽  
Laryngeal Nerve ◽  
Node Dissection ◽  
Robot Assisted ◽  
Stepwise Approach ◽  
Left Recurrent Laryngeal Nerve ◽  
The Right

Abstract Description This video showed the stepwise approach for robot-assisted thoracoscopic left recurrent laryngeal nerve lymph node dissection. With the patient lying in the left semiprone position, a total of five trocars were positioned. Left RLN LND was begun by releasing the right esophagotracheal band. Subsequently, the trachea was gradually rotated clockwise through the application of a gentle pressure on the left edge of the tracheal cartilage with the goal of exposing and releasing the left esophagotracheal band. After the complete release of the bilateral esophagotracheal band, the esophagus was retracted toward the dorsal side with the right first robotic arm. Simultaneously, an assistant rolled back the trachea using a forceps grasping a small piece of gauze, with the aim of improving operative exposure. The left RLN was identified in the middle of the soft tissue between the trachea and the esophagus. Dissection was started from the ventral side RLN nodes and subsequently continued toward the dorsal side until the total skeletonization of the left RLN Disclosure All authors have declared no conflicts of interest.

scholarly journals Recurrent laryngeal nerve monitoring during totally robot-assisted Ivor Lewis esophagectomy

2020 ◽  
Vol 405 (8) ◽  
pp. 1091-1099
Author(s):  
J. I. Staubitz ◽  
P. C. van der Sluis ◽  
F. Berlth ◽  
F. Watzka ◽  
F. Dette ◽  
...  
Keyword(s):  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Laryngeal Nerve ◽  
Node Dissection ◽  
Robot Assisted ◽  
Nerve Monitoring ◽  
Ivor Lewis ◽  
Ivor Lewis Esophagectomy ◽  
Vocal Cord Paresis ◽  
The Right

Abstract Purpose The robot-assisted approach for Ivor Lewis esophagectomy offers an enlarged, three-dimensional overview of the intraoperative situs. The vagal nerve (VN) can easily be detected, preserved, and intentionally resected below the separation point of the recurrent laryngeal nerve (RLN). However, postoperative vocal cord paresis can result from vagal or RLN injury during radical lymph node dissection, presenting a challenge to the operating surgeon. Methods From May to August 2019, 10 cases of robot-assisted minimally invasive esophagectomy (RAMIE) with extended 2-field lymphadenectomy, performed at the University Medical Center Mainz, were included in a prospective cohort study. Bilateral intermittent intraoperative nerve monitoring (IONM) of the RLN and VN was performed, including pre- and postoperative laryngoscopy assessment. Results Reliable mean signals of the right VN (2.57 mV/4.50 ms) and the RLN (left 1.24 mV/3.71 ms, right 0.85 mV/3.56 ms) were obtained. IONM facilitated the identification of the exact height of separation of the right RLN from the VN. There were no cases of permanent postoperative vocal paresis. Median lymph node count from the paratracheal stations was 5 lymph nodes. Conclusion IONM was feasible during RAMIE. The intraoperative identification of the RLN location contributed to the accuracy of lymph node dissection of the paratracheal lymph node stations. RLN damage and subsequent postoperative vocal cord paresis can potentially be prevented by IONM.

Lymph node dissection along the right recurrent laryngeal nerve (RLN)

ASVIDE ◽  
2016 ◽  
Vol 3 ◽  
pp. 450-450
Author(s):  
Hiroshi Makino ◽  
Hiroshi Yoshida ◽  
Hiroshi Maruyama ◽  
Tadashi Yokoyama ◽  
Atsushi Hirakata ◽  
...  
Keyword(s):  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Lymph Node Dissection ◽  
Laryngeal Nerve ◽  
Node Dissection ◽  
The Right

Lymph node dissection along the left recurrent laryngeal nerve (RLN) after esophageal stripping

ASVIDE ◽  
2016 ◽  
Vol 3 ◽  
pp. 449-449
Author(s):  
Hiroshi Makino ◽  
Hiroshi Yoshida ◽  
Hiroshi Maruyama ◽  
Tadashi Yokoyama ◽  
Atsushi Hirakata ◽  
...  
Keyword(s):  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Lymph Node Dissection ◽  
Laryngeal Nerve ◽  
Node Dissection ◽  
Left Recurrent Laryngeal Nerve

Lymph node dissection along the left recurrent laryngeal nerve

ASVIDE ◽  
2018 ◽  
Vol 5 ◽  
pp. 898-898
Author(s):  
Jen-Hao Chuang ◽  
Shun-Mao Yang ◽  
Pei-Wen Yang ◽  
Pei-Ming Huang ◽  
Jang-Ming Lee
Keyword(s):  
Lymph Node ◽  
Recurrent Laryngeal Nerve ◽  
Lymph Node Dissection ◽  
Laryngeal Nerve ◽  
Node Dissection ◽  
Left Recurrent Laryngeal Nerve
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