Experience-Based Procedure Card for Robotic McKeown's Esophagectomy Using SSI Mantra Indian Robotic System

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• McKeown's esophagectomy is a complex procedure for esophageal cancer.
• Standardized guidance for robotic McKeown's esophagectomy using the SSI Mantra system is lacking.
• Robotic approaches offer potential benefits in precision and minimally invasive surgery.

Purpose of the Study:

• To develop a comprehensive procedural roadmap for robotic McKeown's esophagectomy with the SSI Mantra system.
• To evaluate the feasibility, surgical efficiency, and short-term outcomes of this robotic approach.
• To assess the impact on oncological results, morbidity, and patient recovery.

Main Methods:

• A prospective single-arm study involving 26 patients undergoing robotic McKeown's esophagectomy.
• Development and implementation of a detailed procedural roadmap covering all surgical phases.
• Data collection on operative metrics, oncological outcomes, complications, and recovery.

Main Results:

• All 26 procedures were completed robotically without conversion.
• Mean operative time was 7 hours with 96.6 mL blood loss.
• High R0 resection rate (100%) and average lymph node yield of 21.
• Low rates of major complications, including 7.7% anastomotic leak and 3.8% chyle leak.
• Mean hospital stay of 4.5 days, with 96.2% of patients catheter-free by postoperative day 1.

Conclusions:

• The SSI Mantra robotic system facilitates precise and minimally invasive McKeown's esophagectomy.
• The developed procedural roadmap enhances surgical efficiency and reproducibility.
• The technique demonstrates favorable short-term oncological efficacy and low morbidity, warranting further investigation for long-term outcomes.