Robotic Enucleation of Esophageal Leiomyoma

Esophageal leiomyoma is a rare benign tumor of the esophagus. Depending on local complications, complete resection is the treatment of choice. Minimally invasive surgical enucleation should be performed if endoscopic dissection is not possible. In this manuscript, we describe the technique for robotic enucleation of a mid-third esophageal leiomyoma. A 58-year-old patient presented with increasing dysphagia to our outpatient clinic. Endoscopy revealed a submucosal tumor at around 25 cm measured from the upper incisors. CT scan showed an esophageal tumor measuring 7 cm in diameter between the junction of the azygos vein and the tracheal bifurcation. A biopsy taken from the specimens indicated the presence of leiomyoma. After discussion in the multidisciplinary tumor board, surgical resection was recommended. The operation was performed using a robotic system with a four-arm technique. Enucleation of the tumor succeeded without damaging the esophageal mucosa and without any other intraoperative complications. The postoperative course was uneventful, and oral food intake was started on postoperative day 1. Wound healing was unremarkable. The patient was discharged after 5 days. Histological examination confirmed the diagnosis of esophageal leiomyoma. The goal of this article is to present the state-of-the-art technique for the surgical removal of an esophageal leiomyoma as an organ-sparing procedure. This approach may serve as a valuable resource for surgeons seeking to provide optimal care for their patients.