Related Experiment Video
Updated: Sep 15, 2025
09:40
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
13.8K
Learning curve of Robotic Assisted Minimally Invasive Ivor Lewis Esophagectomy (RAMIE): initial experience
Andres Ramos-Fresnedo1, Keouna Pather1, Chelsea R Yap1
1Department of Surgery, University of Florida, 655 8 thStreet S, Jacksonville, FL, 32209, USA.
Surgical Endoscopy
|July 17, 2025
Summary
Robotic Assisted Minimally Invasive Ivor Lewis Esophagectomy (RAMIE) demonstrates a short learning curve for surgeons. Proficiency was achieved within 55 cases, with no significant increase in blood loss, suggesting a safe implementation.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Robotic Surgery
Background:
- Implementing Robotic Assisted Minimally Invasive Ivor Lewis Esophagectomy (RAMIE) requires evaluation of its learning curve and perioperative outcomes.
- Tertiary referral centers are key sites for adopting advanced surgical techniques.
Purpose of the Study:
- To assess the learning curve and perioperative outcomes of RAMIE.
- To identify proficiency milestones for operative time and blood loss during RAMIE implementation.
Main Methods:
- Retrospective review of 70 consecutive RAMIE procedures (June 2019-June 2024).
- Analysis of operative time, estimated blood loss (EBL), conversion rates, lymph node yield, margin positivity, and mortality.
- Cumulative sum (CUSUM) analysis for proficiency; multivariable General Linear Model (GLM) for factors influencing operative time.
Main Results:
- Technical proficiency in RAMIE was achieved by the 55th case.
- No significant changes in intraoperative blood loss were observed.
- Patient sex was significantly associated with operative time (p < .001); overall survival varied significantly by cancer stage (p = .008).
Conclusions:
- RAMIE exhibits a short learning curve, indicating efficient adoption.
- Further prospective studies comparing robotic and non-robotic esophagectomy outcomes are recommended.
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