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Updated: May 22, 2025
Robotics in Surgery: A Modular Robotic Platform Driven Gastric Wedge Resection
Published on: February 7, 2025
A novel robotic technique for creating the retrosternal route in gastric conduit reconstruction
Toshikatsu Tsuji1, Noriyuki Inaki1, Kenta Doden1
1Department of Gastrointestinal Surgery/Breast Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
Background:
The optimal reconstruction route after esophagectomy remains controversial. The retrosternal route has the advantage of a lower risk of fatal complications. However, the blind maneuver to create a retrosternal route may cause bleeding and pleural injury. Herein, we report a novel robotic technique for creating a retrosternal route.
Methods:
This study included 43 consecutive patients with esophageal cancer who underwent robot-assisted minimally invasive esophagectomy with robotic retrosternal route reconstruction between April 2021 and December 2023. Clinicopathological findings and perioperative outcomes, including the time required to create the retrosternal route, were retrospectively analyzed. The creation times were also compared among surgeons.
Results:
The median age and body mass index of the patients were 68 years (range: 46-80) and 21.4 kg/m2 (range: 16.6-30.2 kg/m2), respectively. Twenty-six patients (60%) received neoadjuvant chemotherapy. The median time to create the retrosternal route was nine minutes (range, 5-14 min). No cases showed pleural injury or postoperative hemorrhage associated with this procedure. There was no significant difference in the time taken to create the retrosternal route between the four surgeons (p = 0.434).
Conclusions:
Robotic creation of a retrosternal route for gastric conduit reconstruction is simple, easy to learn, and results in a safe and feasible procedure.
