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CC BY-NC-ND 4.0 · Thorac Cardiovasc Surg
DOI: 10.1055/a-2405-2708
How to Do It

Single-Port da Vinci Robot–Assisted Cervical Esophagectomy: How to Do It

Edin Hadzijusufovic‡   *
1   Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
,
Vladimir J. Lozanovski‡   *
1   Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
,
Eva-Verena Griemert
2   Department of Anesthesia, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
,
Luca Bellaio
1   Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
,
Hauke Lang
1   Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
,
Peter P. Grimminger 
1   Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Abstract

Minimally invasive esophagectomies, including robot-assisted procedures, have demonstrated superiority over traditional open surgery. Despite the prevalence of transhiatal and transthoracic approaches, cervical access is less common in minimally invasive esophageal surgery. Advancements in robotic systems, such as the da Vinci Single Port (SP), enable controlled transcervical extrapleural mediastinoscopic access, potentially reducing pulmonary complications and extending surgical options to patients with comorbidities. The da Vinci SP robot-assisted cervical esophagectomy (SP-RACE) employs an SP and laparoscopic approach, demonstrating feasibility with comparable lymphadenectomy and recurrent nerve palsy rates to transthoracic methods. This technique, performed for the first time in Europe at the University Hospital Mainz, involves a transcervical SP phase that allows for effective mediastinal dissection and esophageal mobilization. Despite technical challenges due to limited space, robotic systems enhance controlled access and eliminate arm collision. The da Vinci SP platform's advantages include improved triangulation, fewer interferences, and better control of instruments in confined spaces. This novel approach shows promise for patients with high esophageal tumors and those unsuitable for transthoracic surgery, warranting further investigation into its clinical utility and reproducibility.

Keywords

minimally invasive surgery - robotics - esophageal surgery

Authors' Contribution

E.H. and V.J.L. wrote the manuscript. E.H., V.J.L., E.V.G., L.B., H.L., and P.P.G. participated in conceptualization, methodology, supervision, and review of the final draft. All authors have read and agreed to the published version of the manuscript. E.H. and V.J.L. contributed equally to this manuscript.


* These authors contributed equally to this study.




Publication History

Received: 09 June 2024

Accepted: 05 August 2024

Accepted Manuscript online:
29 August 2024

Article published online:
29 September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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