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Na et al. Mini-invasive Surg 2024;8:31 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2024.10

Review Open Access

Dissection of the lymph nodes along the recurrent

laryngeal nerve in robotic esophagectomy

Bubse Na, Chang Hyun Kang
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul 03080, Republic of Korea.

Correspondence to: Dr. Chang Hyun Kang, Department of Thoracic and Cardiovascular Surgery, Seoul National University
Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea. E-mail: chkang@snu.ac.kr

How to cite this article: Na B, Kang CH. Dissection of the lymph nodes along the recurrent laryngeal nerve in robotic
esophagectomy. Mini-invasive Surg 2024;8:31. https://dx.doi.org/10.20517/2574-1225.2024.10

Received: 29 Jan 2024 First Decision: 6 Sep 2024 Revised: 28 Oct 2024 Accepted: 8 Nov 2024 Published: 15 Nov 2024

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

Abstract
Lymph node (LN) metastasis serves as a pivotal prognostic determinant in esophageal cancer, particularly in cases
of squamous cell carcinoma (SqCC). The involvement of LN metastasis frequently extends to the LNs along the
recurrent laryngeal nerve (RLN). Radical dissection of these nodes is imperative for precise staging and the
prevention of loco-regional recurrence. Historically, the emphasis on RLN node dissection has been evident in
numerous literature, establishing it as a mandatory procedure in different countries. Nevertheless, the risk of RLN
palsy following such dissection is a substantial concern, given its association with significant postoperative
complications and long-term implications for quality of life. Recent literature has highlighted RLN node dissection in
robotic surgery, demonstrating favorable outcomes in comparison to alternative surgical modalities. This review
paper aims to comprehensively assess prior publications on this subject, elucidating the outcomes and implications
of RLN node dissection in robotic esophagectomy (RE).

Keywords: Esophageal cancer, robotic surgery, recurrent laryngeal nerve, survival

INTRODUCTION
Lymph node (LN) metastasis is one of the most important prognostic factors in esophageal cancer. In
esophageal squamous cell carcinoma (SqCC), bidirectional LN metastasis happens. In upward lymphatic
metastasis, the metastasis to the LNs along the recurrent laryngeal nerve (RLN) is most common. The
complete dissection of the LNs along the RLN is an important procedure for the accurate staging and the

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