John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


Robot-assisted minimally invasive esophagectomy: Where are we now? Volume 29, issue 3, March 2022


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Hôpitaux universitaires Saint Louis-Lariboisière, Service de chirurgie viscérale, carcinologique et endocrinienne, 1 avenue Claude-Vellefaux, 75010 Paris
* Correspondance : F. Jeune

Esophagectomy for cancer is a surgery associated with an overall morbidity greater than 50%. Hybrid or total minimally invasive esophagectomy result in lower severe complications, lower postoperative pain and better postoperative quality of life, leading to a shorter functional recovery and length of hospital stay. Nevertheless, mini-invasive esophagectomy is a demanding procedure, especially for the thoracic part and the intra-thoracic anastomoses. It is requiring a long learning curve, and a large number of procedures that may limited the widespread of minimally approach for all esophagectomy. The surgical robot has several advantages including a high- definition 3D vision controlled by the surgeon and articulated instruments that improve surgical ability, especially for inexperienced surgeons in laparoscopy. Robotic systems may contribute to implement minimally invasive approach for complex procedures such as esophagectomy. Robot-assisted minimally invasive esophagectomy is associated with a reduction of overall surgery and cardiopulmonary complications compared to open surgery with similar oncological outcomes. The benefit of the robotic approach over the conventional minimally invasive approach is being evaluated. The robotic approach may improve lymphadenectomy and increase the rate of complete macroscopic resection in locally advanced tumor. It also could increase the feasibility and safety of intra-thoracic anastomoses with minimally invasive approach. The robotic system appears to promote the development of major innovations and secure surgical procedures. This mini-review is an update of the main data published in the literature that have evaluated the robotassisted- minimally-invasive esophagectomy in esophageal cancer.