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Page 6 of 8 Triantafyllou et al. Mini-invasive Surg 2023;7:31 https://dx.doi.org/10.20517/2574-1225.2023.48

Table 2. Landmark ongoing and recently completed randomised trials on the comparison between MIE and RAMIE
Start Expected Anticipated primary
Trial Origin Surgical arms
date number of cases endpoint
[31]
RAMIE 7/2017 China 360 Totally MIE, chest/neck Totally RAMIE, 5-year survival
anastomosis chest/neck anastomosis
[32]
ROBOT-2 1/2021 Germany, 218 Totally MIE, chest Totally RAMIE, chest Number of lymph nodes
Netherlands, anastomosis anastomosis resected
Switzerland
[33]
REVATE 10/2018 China 190 Hybrid: Totally RAMIE Extent of
thoracoscopy, lymphadenectomy
laparotomy/
laparoscopy
MIE: Minimally invasive esophagectomy; RAMIE: robot-assisted minimally invasive esophagectomy.

CONCLUSION
This narrative review demonstrated the available totally robotic and hybrid techniques for forming the
esophagogastric anastomosis during RAMIE. The existing variety of the anastomotic options in MIE has
been implemented in robotic resections; hence, a great diversity of tips and tricks, results, and
recommendations are being discussed in the literature. Either hand-sewn or mechanical stapling, each
technique presents a few advantages and challenges, and most esophageal surgeons incorporate the skills
they are more familiar with from open esophagectomy or MIE. The hand-sewn suturing and the linear
stapling can complete a totally robotic reconstruction, whereas the circular stapler requires undocking of the
robotic arms and a trained assistant. Regardless of the preferred approach, safety and radicality, along with
accurate reports of the surgical outcomes and complications, are pivotal. This aims to improve the technical
experience and maximally take advantage of the robotic technique.

DECLARATIONS
Authors’ contributions
Completed the search of the literature and conducted the manuscript: Triantafyllou T
Revised the manuscript and completed the final editing: Sgromo B

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
All authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2023.