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Modified exposure method for gastric mobilization in robot-assisted esophagectomy
Yu Zheng1, Xi-Wen Zhao2, Han-Lu Zhang1
1Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China.
Journal of Thoracic Disease
|January 10, 2018
Summary
A new thread retraction (TR) technique significantly reduces gastric mobilization time during robot-assisted McKeown esophagectomy compared to conventional grasper retraction (GR). This safe and effective method improves operative efficiency for esophageal cancer surgery.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Robotic esophagectomy offers advantages but presents challenges in gastric mobilization.
- Conventional grasper retraction (GR) can be time-consuming.
- A modified thread retraction (TR) technique was developed to improve gastric exposure.
Purpose of the Study:
- To describe a modified thread retraction (TR) technique for gastric mobilization in robotic esophagectomy.
- To prospectively compare surgical outcomes between the TR technique and conventional grasper retraction (GR).
Main Methods:
- A prospective comparative study included 59 patients undergoing robot-assisted McKeown esophagectomy.
- Patients were divided into GR (n=27) and TR (n=32) groups.
- The TR group utilized a polyester tape and thread loop for exposing gastric vessels.
Main Results:
- The median gastric mobilization time was significantly shorter in the TR group (P=0.005).
- No significant differences were observed in blood loss (P=0.573), lymph node dissection (P=0.386), or postoperative morbidity (P=0.942) between groups.
- No 30-day postoperative mortality occurred.
Conclusions:
- The thread retraction (TR) technique is a safe and effective method for gastric mobilization in robot-assisted McKeown esophagectomy.
- TR requires less operating time and provides an excellent operative field compared to GR.
- This technique addresses limitations of robotic esophagectomy during gastric mobilization.
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