Robot-Assisted Oesophagectomy: Recommendations Towards a Standardised Ivor Lewis Procedure

Area of Science:

• Minimally Invasive Surgery
• Surgical Robotics
• Gastrointestinal Surgery

Background:

• Robotic-assisted esophageal surgery, particularly the Ivor Lewis procedure, is gaining traction but lacks standardization.
• Existing reports are often small case series, indicating the procedure is still in its early implementation phase.

Purpose of the Study:

• To develop and present a standardized robotic-assisted Ivor Lewis surgical workflow.
• To facilitate the safe and efficient adoption of robotic surgery in esophageal procedures.

Main Methods:

• A consensus-based approach involving experienced esophageal surgeons from seven German robotic university centers.
• A workshop combining expert opinion exchange with step-by-step procedural re-enactment in a cadaver lab.

Main Results:

• A standardized, step-by-step robotic-assisted Ivor Lewis surgical workflow was successfully developed.
• This standardized workflow has been implemented and is currently in clinical use across participating centers.

Conclusions:

• Standardization of the robotic-assisted Ivor Lewis procedure is crucial for patient safety and error reduction.
• A standardized workflow can significantly shorten the learning curve for introducing robotic surgery into clinical practice.