Robot-assisted thoracoscopic esophagectomy (RAMIE) was introduced to reduce the morbidity and improve the oncologic outcomes of transthoracic esophagectomy. The aim of this study was to assess intraoperative data, postoperative complications and short term oncologic results for robot-assisted thoracoscopic esophagectomy for esophageal cancer.
Between October 2003 and September 2014, 240 patients with resectable esophageal cancer underwent robot-assisted thoracoscopic oesophagectomy in the UMC Utrecht. Clinical data were collected prospectively.
Median operating time for the thoracoscopic phase was 180 min (range 93–345 min) and for the total procedure 386 min (range 185–923 min). Median blood loss for the thoracoscopic phase was 150ml (range 20–5300 ml) and for the total procedure 380 ml (range 50–5300 ml). Conversions of the thoracoscopic phase were observed in 10% of all cases.
Median postoperative ventilation time was 0 days (0-64 days), intensive care stay 1 day (1-136 days) and hospital stay 16 days (8-182 days). Pulmonary complications were most common (33%) anastomotic leakage was observed in 24% of all patients. In hospital mortality was 5%. A radical resection (R0) was achieved in 91% of all patients with a median number of 27 dissected lymph nodes.
Conclusion: Robot-assisted thoracoscopic oesophagectomy was feasible, safe and effective with a high percentage of R0 resections and a lymph node harvest comparable to open surgery. Compared to open surgery, robot-assisted thoracoscopic oesophagectomy shows reduced morbidity with at least comparable pathological results.
Richard van Hillegersberg, MD, PhD
Department of Surgery, G04.228
Unversity Medical Center Utrecht, The Netherlands
Richard van Hillegersberg attended medical school in Rotterdam, the Netherlands. In 1990 he received a research grant from the Dutch Digestive Foundation, that enabled him to perform PhD research on the local treatment of liver metastases at the Department of Surgery, Erasmus MC in Rotterdam. In 1993 he received his PhD with honor. After obtaining his MD in 1994, he was a resident of Surgery in Rotterdam and was registered as general surgeon in 2000. From 2001-2002 he was a fellow of Surgical Oncology in the Academic Medical Center and Antoni van Leeuwenhoek Netherlands Cancer Center Amsterdam. Since 2003 he is appointed as staff surgeon at the University Medical Center Utrecht. From 2009 he is a full professor of gastrointestinal oncology and program leader of the GI-Oncology department. His clinical interests are upper gastrointestinal tract and hepatobiliary surgery. Research is focused on minimally invasive and robotic surgery, surgical imaging, genetic profiling and radiofrequency ablation for cancer. He has authored and co-authored over 150 articles in international peer-reviewed journals. He is past president of the Dutch GI Surgical Association, past board member of the Dutch Surgical Association, board member of the Dutch Society for liver surgery and the European Digestive Surgery.