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Liu et al. Mini-invasive Surg 2020;4:44 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.20

Review Open Access

Trends in the evolution to robot-assisted minimally
invasive thoracoscopic esophagectomy

Jiajia Liu, Satoru Motoyama, Yusuke Sato, Akiyuki Wakita, Yuta Kawakita, Yushi Nagaki, Hiromu Fujita,
Kazuhiro Imai, Yoshihiro Minamiya

Esophageal Surgery, Akita University Hospital, Akita 010-0043, Japan.
Correspondence to: Dr. Satoru Motoyama, Esophageal Surgery, Akita University Hospital, 1-1-1 Hondo, Akita 010-8543, Japan.
E-mail: motoyama@doc.med.akita-u.ac.jp
How to cite this article: Liu J, Motoyama S, Sato Y, Wakita A, Kawakita Y, Nagaki Y, Fujita H, Imai K, Minamiya Y. Trends in the
evolution to robot-assisted minimally invasive thoracoscopic esophagectomy. Mini-invasive Surg 2020;4:44.
http://dx.doi.org/10.20517/2574-1225.2020.20
Received: 13 Feb 2020 First Decision: 1 Apr 2020 Revised: 30 Apr 2020 Accepted: 24 Jun 2020 Published: 19 Jul 2020

Academic Editor: Itasu Ninomiya Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Much effort has been made to improve outcomes and/or minimize the invasiveness of esophagectomy for thoracic
esophageal cancer. This has led to the evolution from open esophagectomy to thoracoscopic minimally invasive
esophagectomy (MIE), and from MIE to robot-assisted minimally invasive esophagectomy (RAMIE). RAMIE is
being applied clinically to overcome the limitations of MIE. In this article, we review the trends in the evolution
from thoracoscopic MIE to RAMIE. It has now been demonstrated that RAMIE is both safe and feasible, and may
decrease morbidity and mortality rates associated with esophagectomy and improve oncological outcomes. On
the other hand, there are still many problems that need to be solved.

Keywords: Esophagectomy, esophageal cancer, robot-assisted esophagectomy, thoracoscopic esophagectomy

INTRODUCTION
Esophageal cancer is the 6th highest cause of cancer mortality worldwide due, in large part, to its high
[1]
potential for metastasis . The most reliable curative treatment is surgery entailing radical resection of
the esophagus with extended lymphadenectomy in the mediastinum, abdomen, and neck. However,
[2,3]
esophagectomy is associated with high postoperative morbidity (about 40%) and mortality (about 3.4%) .
To improve outcomes, patients are often treated with multimodal treatments such as neoadjuvant

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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