scholarly journals Application of full lateral decubitus position with cephalic parallel approach in robotic-assisted minimally invasive esophagectomy

2019 ◽  
Vol 11 (8) ◽  
pp. 3250-3256
Author(s):  
Yunke Zhu ◽  
Lin Ma ◽  
Lunxu Liu ◽  
Yidan Lin
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Lateral Decubitus Position ◽  
Robotic Assisted ◽  
Invasive Esophagectomy ◽  
Lateral Decubitus

Minimally invasive oesophagectomy in the prone versus lateral decubitus position: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Dimitrios Schizas ◽  
Dimitrios Papaconstantinou ◽  
Anastasia Krompa ◽  
Antonios Athanasiou ◽  
Tania Triantafyllou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Meta Analysis ◽  
Lateral Decubitus Position ◽  
Prone Positioning ◽  
Respiratory Complications ◽  
Invasive Esophagectomy ◽  
Postoperative Respiratory Complications ◽  
Lateral Decubitus

Abstract The thoracic phase of minimally invasive esophagectomy was initially performed in the lateral decubitus position (LDP); however, many experts have gradually transitioned to a prone position (PP) approach. The aim of the present systematic review and meta-analysis is to quantitatively compare the two approaches. A systematic literature search of the MEDLINE, Embase, Google Scholar, Web of Knowledge, China National Knowledge Infrastructure and ClinicalTrials.gov databases was undertaken for studies comparing outcomes between patients undergoing minimally invasive esophageal surgery in the PP versus the LDP. In total, 15 studies with 1454 patients (PP; n = 710 vs. LDP; n = 744) were included. Minimally invasive esophagectomy in the PP provides statistically significant reduction in postoperative respiratory complications (Risk ratios 0.5, 95% confidence intervals [CI] 0.34–0.76, P < 0.001), blood loss (weighted mean differences [WMD] –108.97, 95% CI –166.35 to −51.59 mL, P < 0.001), ICU stay (WMD –0.96, 95% CI –1.7 to −0.21 days, P = 0.01) and total hospital stay (WMD –2.96, 95% CI –5.14 to −0.78 days, P = 0.008). In addition, prone positioning increases the overall yield of chest lymph node dissection (WMD 2.94, 95% CI 1.54–4.34 lymph nodes, P < 0.001). No statistically significant difference in regards to anastomotic leak rate, mortality and 5-year overall survival was encountered. Subgroup analysis revealed that the protective effect of prone positioning against pulmonary complications was more pronounced for patients undergoing single-lumen tracheal intubation. A head to head comparison of minimally invasive esophagectomy in the prone versus the LDP reveals superiority of the former method, with emphasis on the reduction of postoperative respiratory complications and reduced length of hospitalization. Long-term oncologic outcomes appear equivalent, although validation through prospective studies and randomized controlled trials is still necessary.

RA04.03: MINIMALLY INVASIVE ESOPHAGECTOMY IN THE LEFT LATERAL DECUBITUS POSITION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 25-25
Author(s):  
Koji Otsuka ◽  
Satoru Goto ◽  
Tomotake Ariyoshi ◽  
Takeshi Yamashita ◽  
Kentaro Motegi ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Lymph Nodes ◽  
Anastomotic Leakage ◽  
Minimally Invasive Esophagectomy ◽  
Lateral Decubitus Position ◽  
Mediastinal Lymph Nodes ◽  
Invasive Esophagectomy ◽  
Left Lateral Decubitus Position ◽  
Lateral Decubitus

Abstract Background We initially performed minimally invasive esophagectomy in a left lateral decubitus position through 5 ports in 1996, and we have now treated over 900 cases using this approach. This position has many benefits, but it also has some drawbacks. We were able to operate with good results after we introduced artificial pneumothorax with CO2 insufflation in 2010. We investigated the short- and long-term outcomes of thoracoscopic surgery for esophageal cancer in the left lateral decubitus position at our institution. Methods From 1996 to 2016, 807 esophageal cancer patients were treated with minimally invasive esophagectomy in the left lateral decubitus position at our hospital. We compared the 289 cases treated in the early period (1996–2005) and 518 cases treated in the late period (2006–2016), in which the procedure was standardized and operator training was established Results The completion rate of thoracoscopic surgery was 99.5%, with the procedure switched to thoracotomy in only 3 patients in whom hemorrhage occurred. The mean intrathoracic operative time was 205.0 min, mean intrathoracic blood loss was 127.3 mL, and mean number of dissected mediastinal lymph nodes was 24.7. The postoperative complications were pneumonia (8.5%), anastomotic leakage (7.5%), and recurrent nerve paralysis (7.8%). The 5-year overall survival rate was 69.5%. Comparison of 289 cases treated in the early period (1996–2005) and 518 cases treated in the late period (2006–2016), revealed significant differences in mean intrathoracic blood loss (174.0 vs. 94.2 mL); number of dissected mediastinal lymph nodes (20.0 vs. 28.4); postoperative hospital stay (33.4 vs. 20.0 days, all P < 0.001); and postoperative anastomotic leakage (13.9% vs. 1.6%, P < 0.0001). In recent operation, we do not have recurrent laryngeal nerve paralysis and hoarseness after we take care of the micro anatomical layer, stretch and thermal damage of recurrent laryngeal nerve when we dissect the lymph node. Conclusion These data indicate significant improvements in intrathoracic blood loss, number of dissected mediastinal lymph nodes, anastomotic leakage, and postoperative hospital stay, reflecting continued improvement of minimally invasive esophagectomy performed in the left lateral decubitus position at our institution. Disclosure All authors have declared no conflicts of interest.

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

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.

Minimally invasive esophagectomy: Lateral decubitus vs. prone positioning; systematic review and pooled analysis

2015 ◽  
Vol 24 (3) ◽  
pp. 212-219 ◽  
Author(s):  
Sheraz R. Markar ◽  
Tom Wiggins ◽  
Stefan Antonowicz ◽  
Emmanouil Zacharakis ◽  
George B. Hanna
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Pooled Analysis ◽  
Prone Positioning ◽  
Invasive Esophagectomy ◽  
Lateral Decubitus
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