Robotic-assisted single-incision gastric mobilization for minimally invasive oesophagectomy for oesophageal cancer: preliminary results

Abstract OBJECTIVES With the gradual acceptance of robotic-assisted surgery to treat oesophageal cancer and the application of a single-port approach in several abdominal procedures, we adopted a single-port technique in robotic-assisted minimally invasive oesophagectomy during the abdominal phase for gastric mobilization and abdominal lymph node dissection. METHODS Robotic-assisted oesophagectomy and mediastinal lymph node dissection in the chest were followed by robotic-assisted gastric mobilization and conduit creation with abdominal lymph node dissection, which were performed via a periumbilicus single incision. The oesophagogastrostomy was accomplished either in the chest (Ivor Lewis procedure) or neck (McKeown procedure) depending on the status of the proximal resection margin. RESULTS The procedure was successfully performed on 11 patients with oesophageal cancer from January 2017 to December 2018 in our institute. No surgical or in-hospital deaths occurred, though we had one case each of anastomotic leakage, pneumonia and hiatal hernia (9%). CONCLUSIONS Robotic single-incision gastric mobilization for minimally invasive oesophagectomy for treating oesophageal cancer seems feasible. Its value in terms of perioperative outcome and long-term survival results awaits future evaluation.

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V02-11 SINGLE-PORT ROBOTIC ASSISTED LAPAROSCOPIC BILATERAL INGUINAL LYMPH NODE DISSECTION

The Journal of Urology ◽

10.1097/ju.0000000000000837.011 ◽

2020 ◽

Vol 203 ◽

pp. e183

Author(s):

Andrew Fang* ◽

Ava Saidian ◽

Jennifer Rosen ◽

Vidhush Yarlagadda ◽

Jeffrey Nix ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Single Port ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Robotic Assisted

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Tips and Tricks To Optimize Efficiency during a Robotic Assisted Minimally Invasive (RAMI) Radical Hysterectomy and Lymph Node Dissection

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2013.08.685 ◽

2013 ◽

Vol 20 (6) ◽

pp. S192

Author(s):

M.S. Hadiashar ◽

D.H. Chamberlain ◽

S.J. Rich

Keyword(s):

Lymph Node ◽

Minimally Invasive ◽

Lymph Node Dissection ◽

Radical Hysterectomy ◽

Tips And Tricks ◽

Node Dissection ◽

Robotic Assisted

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Single Incision Laparoscopic Total Gastrectomy and D2 Lymph Node Dissection for Gastric Cancer Using a Four-Access Single Port: The First Experience

Case Reports in Surgery ◽

10.1155/2013/504549 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Metin Ertem ◽

Emel Ozveri ◽

Hakan Gok ◽

Volkan Ozben

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Laparoscopic Surgery ◽

Total Gastrectomy ◽

Lymph Node Dissection ◽

Single Incision ◽

Single Port ◽

Laparoscopic Total Gastrectomy ◽

Node Dissection ◽

D2 Lymph Node Dissection

Single incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) have been developed to reduce the invasiveness of laparoscopic surgery. SILS has been frequently applied in various clinical settings, such as cholecystectomy, colectomy, and sleeve gastrectomy. So far, there have been four reports on single incision laparoscopic distal gastrectomy and one report on single incision laparoscopic total gastrectomy with D1 lymph node dissection for gastric cancer. In this report, we present our single incision laparoscopic total gastrectomy with D2 lymph node dissection technique using a four-hole single port (OctoPort) in a patient with gastric cancer.

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Does robot-assisted minimally invasive oesophagectomy have superiority over thoraco-laparoscopic minimally invasive oesophagectomy in lymph node dissection?

Diseases of the Esophagus ◽

10.1093/dote/doaa050 ◽

2020 ◽

Author(s):

Xiao-Kun Li ◽

Yang Xu ◽

Hai Zhou ◽

Zhuang-Zhuang Cong ◽

Wen-Jie Wu ◽

...

Keyword(s):

Lymph Node ◽

Blood Loss ◽

Minimally Invasive ◽

Lymph Nodes ◽

Vocal Cord ◽

Lymph Node Dissection ◽

Vocal Cord Palsy ◽

Node Dissection ◽

Lymph Node Yield ◽

Minimally Invasive Oesophagectomy

Summary Although robotic techniques have been used for oesophagectomy for many years, whether robot-assisted minimally invasive oesophagectomy (RAMIE) can actually improve outcomes and surpass thoraco-laparoscopic minimally invasive oesophagectomy (MIE) in the success rate of lymph node dissection remains to be empirically demonstrated. Therefore, we performed this systematic review and meta-analysis of case–control studies to systematically compare the effect of lymph node dissection and the incidence of vocal cord palsy between RAMIE and MIE. The PubMed, EMBASE, and Web of Science databases were systematically searched up to December 1, 2019, for case–control studies that compared RAMIE with MIE. Thirteen articles were included, with a total of 1,749 patients with esophageal cancer, including 866 patients in the RAMIE group and 883 patients in the MIE group. RAMIE yielded significantly larger numbers of total dissected lymph nodes (WMD = 1.985; 95% CI, 0.448–3.523; P = 0.011) and abdominal lymph nodes (WMD = 1.686; 95% CI, 0.420–2.951; P = 0.009) as well as lymph nodes along RLN (WMD = 0.729; 95% CI, 0.348–1.109; P < 0.001) than MIE. Additionally, RAMIE could significantly decrease estimated blood loss (WMD = -11.208; 95% CI, -19.358 to -3.058; P = 0.007) and the incidence of vocal cord palsy (OR = 0.624; 95% CI, 0.411–0.947; P = 0.027) compared to MIE. Compared with MIE, RAMIE resulted in a higher total lymph node yield and a higher lymph node yield in the abdomen and along RLN, along with reduced blood loss during surgery and the incidence of vocal cord palsy. Therefore, RAMIE could be considered to be a standard treatment, with less blood loss, lower incidence of vocal cord palsy, and more radical lymph node dissection, exhibiting superiority over MIE.

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