Robotic assisted Ivor Lewis esophagectomy
Robotic thoracic surgery has been increasingly adopted across the field. Many surgeons have found the articulating instrumentation, better visualization, and improved ergonomics immensely beneficial in either transitioning their practices from open to minimally invasive or enabling increased complexity in their minimally invasive practice. Robotic assisted minimally invasive esophagectomy (RAMIE) remains in the early stages of adoption. Similar to the early era of minimally invasive esophagectomy (MIE), outcomes are plagued by the growing pains of a steep learning curve. Understandably, many in the field find it difficult to justify these worse outcomes in the name of learning a new technology. However, as a new generation of surgeons is trained on the robotics platform and the outcomes become equivocal, the benefits of RAMIE, to both the patient and the surgeon, will come into sharper focus. Herein, we review the technique of a completely robotic assisted Ivor Lewis esophagectomy. We discuss the operative technique for both the abdominal and thoracic portions, including demonstration of port placement as well as 'troubleshooting' scenarios intraoperatively.
