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Ackerman et al. Mini-invasive Surg 2021;5:14 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2021.02

Technical Note Open Access

Robotic Ivor Lewis esophagectomy

James M. Ackerman, James D. Luketich, Inderpal S. Sarkaria

Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Correspondence to: Dr. Inderpal Sarkaria, Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, 200
Lothrop Street, Pittsburgh, PA 15213, USA. E-mail: sarkariais@upmc.edu.
How to cite this article: Ackerman JM, Luketich JD, Sarkaria IS. Robotic Ivor Lewis esophagectomy. Mini-invasive Surg 2021;5:14.
https://dx.doi.org/10.20517/2574-1225.2021.02
Received: 6 Jan 2021 First Decision: 26 Jan 2021 Revised: 7 Feb 2021 Accepted: 23 Feb 2021 Available online: 8 Apr 2021

Academic Editor: Farid Gharagozloo Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

Abstract
The addition of robotic-assistance is the latest evolution of minimally invasive esophageal resection and
reconstruction. Despite the improved visualization, the addition of wristed instrumentation, and improved
ergonomics, there remains a significant learning curve for complex procedures like esophagectomy. In experienced,
high-volume centers, robotic-assisted minimally invasive esophagectomy (RAMIE) has demonstrated outcomes
equivalent to traditional laparoscopic and thoracoscopic minimally invasive esophagectomy. Herein, the RAMIE
procedure is described in detail in key steps. This approach has been established as safe and effective for
esophagectomy.

Keywords: Robotic esophagectomy, esophagectomy, esophageal cancer, Ivor Lewis, robotic-assisted minimally
invasive esophagectomy

INTRODUCTION
Worldwide, esophageal cancer is the seventh most commonly occurring cancer in men and the 13th most
[1]
commonly occurring cancer in women . Overall, there are 572,000 new cases per year and esophageal
cancer carries the sixth-highest overall mortality, being responsible for an estimated 1 in every 20 cancer
[1]
deaths in 2018 . Although also performed for benign diseases, esophageal cancer represents the most
[2]
common indication for esophagectomy . In this work, we outline the general principles of the preoperative
evaluation, technical details of intraoperative steps, and the outcomes of robotic-assisted minimally invasive
esophagectomy (RAMIE).

© The Author(s) 2021. 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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