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Robotic esophagectomy: modified McKeown approach.

David Lehenbauer¹, Kemp H Kernstine¹

¹Department of Cardiothoracic and Vascular Surgery, University of Texas Southwestern, 5323 Harry Hines Boulevard, HA9.134, Dallas, TX 75390-8879, USA.

Thoracic Surgery Clinics

|May 1, 2014

Summary

This study details a robotic approach to esophagolymphadenectomy, a procedure for removing lymph nodes around the esophagus. The technique involves multiple surgical steps for comprehensive cancer staging and treatment.

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Area of Science:

Surgical Oncology
Minimally Invasive Surgery
Gastrointestinal Surgery

Background:

Esophageal cancer management often requires extensive lymph node dissection.
Robotic surgery offers potential advantages in precision and visualization for complex procedures.
A 2-stage, 3-field lymphadenectomy provides comprehensive staging but is technically demanding.

Purpose of the Study:

To describe a standardized robotic technique for 2-stage, 3-field esophagolymphadenectomy.
To outline the key surgical steps and considerations for this advanced procedure.

Main Methods:

Description of a robotic-assisted surgical technique.
Encompasses thoracic esophagectomy, cervical, thoracic, and abdominal lymphadenectomy.
Includes thoracic duct ligation, gastric tube creation, and esophagogastric anastomosis.

Keywords:

Esophageal cancer Esophagectomy Minimally invasive surgery Robotics

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Main Results:

The described technique facilitates a systematic and comprehensive lymph node dissection.
Robotic assistance allows for precise execution of complex anastomotic and reconstructive steps.
Jejunostomy feeding tube placement is integrated into the procedure.

Conclusions:

Robotic 2-stage, 3-field esophagolymphadenectomy is a feasible and detailed surgical approach.
This technique aims to improve lymph node staging and potentially oncologic outcomes in esophageal cancer surgery.