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Murillo et al. Mini-invasive Surg. 2025;9:7 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2024.55

Review Open Access

Comparison of conventional and robotic-assisted

minimally invasive esophagectomy for esophageal
cancer

1
1
Alyssa Murillo , Riley Brian , Daniel S. Oh 2,3
1
Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA.
2
Department of Surgery, University of Southern California, Los Angeles, CA 90033, USA.
3
Intuitive Surgical, Sunnyvale, CA 94086, USA.
Correspondence to: Dr. Daniel S. Oh, Department of Surgery, University of Southern California, 1500 San Pablo St, Los Angeles,
CA 90033, USA. E-mail: danieloh.md@gmail.com
How to cite this article: Murillo A, Brian R, Oh DS. Comparison of conventional and robotic-assisted minimally invasive
esophagectomy for esophageal cancer. Mini-invasive Surg. 2025;9:7. https://dx.doi.org/10.20517/2574-1225.2024.55

Received: 25 Jun 2024 First Decision: 1 Nov 2024 Revised: 18 Jan 2025 Accepted: 6 Feb 2025 Published: 4 Mar 2025

Academic Editor: Giulio Belli Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Conventional minimally invasive esophagectomy (MIE) and robotic-assisted MIE (RAMIE) have increased in
prevalence across the world for the management of esophageal cancer. Both minimally invasive modalities have
demonstrated decreased morbidity, with preservation of oncologic outcomes, when compared to open
esophagectomy. A limitation of conventional MIE is the use of rigid instruments with 2D visualization leading to a
prolonged learning curve and extended operative times. RAMIE offers both improved visualization with 3D video
capable of magnification and full dexterity with wristed instruments. To date, retrospective and randomized
controlled trials demonstrate overall higher harvest during lymphadenectomy by RAMIE compared to MIE, though
more studies are needed to determine definitive impact on oncologic outcomes and long-term survival. RAMIE
showed superiority for lymphadenectomy after neoadjuvant therapy and for bilateral recurrent laryngeal nerve
(RLN) lymphadenectomy with decreased rates of RLN paralysis. Current data suggests no overall cost difference
between the two modalities. Ongoing studies will further clarify the role for RAMIE in esophageal adenocarcinoma
(EA) and the outcomes of robotic/MIE hybrid techniques.

Keywords: Esophageal cancer, robotic-assisted minimally invasive esophagectomy, minimally invasive
esophagectomy, esophageal cancer surgery

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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