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Kikuchi et al. Mini-invasive Surg 2024;8:8 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2023.88

Technical Note Open Access

Standardization and short-term outcomes of robot-

assisted minimally invasive esophagectomy in the
semi-prone position

1
1
1
Hirotoshi Kikuchi 1 , Eisuke Booka , Ryoma Haneda 1 , Tomohiro Murakami , Tomohiro Matsumoto ,
Yoshihiro Hiramatsu 2 , Hiroya Takeuchi 1
1
Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan.
2
Department of Perioperative Functioning Care and Support, Hamamatsu University School of Medicine, Hamamatsu 431-3192,
Japan.
Correspondence to: Dr. Hiroya Takeuchi, Department of Surgery, Hamamatsu University School of Medicine, 1-20-1
Handayama, Chuo-ku, Hamamatsu 431-3192, Japan. E-mail: takeuchih@hama-med.ac.jp
How to cite this article: Kikuchi H, Booka E, Haneda R, Murakami T, Matsumoto T, Hiramatsu Y, Takeuchi H. Standardization
and short-term outcomes of robot-assisted minimally invasive esophagectomy in the semi-prone position. Mini-invasive Surg
2024;8:8. https://dx.doi.org/10.20517/2574-1225.2023.88

Received: 23 Jul 2023 First Decision: 26 Apr 2024 Revised: 23 May 2024 Accepted: 5 Jun 2024 Published: 11 Jun 2024

Academic Editors: Farid Gharagozloo, Giulio Belli Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Robot-assisted minimally invasive esophagectomy (RAMIE) has recently been developed and is increasingly
performed for thoracic esophageal and esophagogastric junction (EGJ) cancers. At our institute, we performed
RAMIE in the semi-prone position using the da Vinci Xi system with two- or three-field lymphadenectomy in 91
patients with resectable thoracic esophageal or EGJ cancers between October 2018 and March 2023. During this
period, we improved and standardized the surgical procedures to perform precise and safe mediastinal
lymphadenectomies and minimize postoperative complications. The rates of major operative morbidities (C-D
grade, ≥ I) were acceptable (recurrent laryngeal nerve paralysis, 6.6%; pneumonia, 9.9%; atelectasis, 6.7%;
anastomotic leak, 14.3%). Both operative and 30-day mortality rates were 0%. In this technical note, we present
our standardized surgical techniques for RAMIE in the semi-prone position for esophageal and EGJ cancers.

Keywords: Robot, da Vinci, esophagectomy, lymphadenectomy, esophageal cancer

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
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