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Updated: Oct 4, 2025
Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
Robotic-assisted surgery for esophageal submucosal tumors: a single-center case series
Caterina Froiio1,2, Felix Berlth1, Giovanni Capovilla1
1Mainz University, Johannes Gutenberg Universitat Mainz, Mainz, Germany.
Abstract:
Esophageal submucosal tumors (SMTs) are rare heterogenous clinical entities. The surgical resection can be performed in different surgical approaches. However, the robotic surgical strategy is poorly documented in the treatment of SMTs. We present our series of operated esophageal SMTs approached via robotic-assisted surgery. Six patients with symptomatic esophageal submucosal tumors underwent robotic surgery within a 3-year period. The performed procedures were robotic-assisted enucleation, robotic esophagectomy (RAMIE) and reverse hybrid robotic esophagectomy. Patients' clinical data, intra/postoperative outcomes, and histopathological features were retrieved from the institution's prospective database. Five of six patients were scheduled for upfront surgery: four underwent robotic enucleation (three leiomyoma and one suspected GIST) and one underwent reverse hybrid robotic esophagectomy (suspected GIST). One patient, diagnosed with GIST, was treated with neoadjuvant Imatinib therapy, before undergoing a RAMIE. No major intra-operative complications were recorded. Median length of stay was 7 days (6-50), with a longer post-operative course in patients who underwent esophagectomy. Clavien-Dindo > 3a complications occurred in two patients, aspiration pneumonia and delayed gastric emptying. The final histopathological and immuno-histochemical diagnosis were leiomyoma, well-differentiated GIST, low-grade fibromyxoid sarcoma and Schwannoma. Robotic-assisted surgery seems to be a promising option for surgical treatment strategies of benign or borderline esophageal submucosal tumors.
Insights
Robotic surgery offers a promising approach for treating esophageal submucosal tumors (SMTs). This study shows favorable outcomes for robotic-assisted enucleation and esophagectomy in six patients.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Esophageal submucosal tumors (SMTs) are uncommon and diverse.
- Surgical resection is a primary treatment, but robotic approaches are underrepresented in literature.
- Limited data exists on the efficacy and safety of robotic surgery for SMTs.
Purpose of the Study:
- To evaluate the feasibility and outcomes of robotic-assisted surgery for esophageal submucosal tumors.
- To document the surgical techniques and patient results in a series of SMT cases treated robotically.
Main Methods:
- A retrospective review of six patients with symptomatic esophageal SMTs treated with robotic surgery over three years.
- Procedures included robotic-assisted enucleation, robotic-assisted minimally invasive esophagectomy (RAMIE), and reverse hybrid robotic esophagectomy.
- Data collected included clinical information, intraoperative and postoperative outcomes, and histopathological findings.
Main Results:
- No major intraoperative complications were observed.
- Median hospital stay was 7 days, with longer stays for esophagectomy patients.
- Two patients experienced Clavien-Dindo grade >3a complications: aspiration pneumonia and delayed gastric emptying.
- Final diagnoses included leiomyoma, GIST, low-grade fibromyxoid sarcoma, and Schwannoma.
Conclusions:
- Robotic-assisted surgery appears to be a viable and promising option for the surgical management of benign and borderline esophageal submucosal tumors.
- Further research is warranted to establish robotic surgery as a standard treatment for SMTs.
