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Home Conference IITS 2019  Robotic Esophagectomy
Robotic Esophagectomy
Prof. ChangHyun Kang Seoul National University Hospital | Republic of Korea Speciality : Department of Thoracic & Cardiovascular Surgery

Minimally invasive esophagectomy (MIE) has several advantages over open esophagectomy. Reducing complication and enhancing early recovery are the most commonly expected benefits of MIE. Robotic esophagectomy (RE) is another platform of MIE which is based on thoracoscopic and laparoscopic esophagectomy. However, more advanced technological features are embedded in robotic system and it aims to achieve safe, easy, confident, and better operation compared to conventional thoraco-laparoscopic esophagectomy.

Compared to rapid global adoption of robotic lobectomy in lung cancer surgery, establishment of RE has been relatively slow, partly because of the complexity of the operation and partly because of financial issues in each country. Recently a randomized controlled study comparing robotic esophagectomy and open esophagectomy was reported in the literature with favorable early outcomes in RE group, which is the first confident evidence on the superiority of RE over open esophagectomy.

Although it has been documented that RE could achieve better early outcome, many surgeons are expecting the results of long-term outcomes after RE. Because meticulous mediastinal lymph node dissection is possible, better control of nodal recurrence has been expected after RE. However, currently we don’t have enough evidence for the long-term result of RE. The other features that is promising in RE is short learning period. Because of the steep learning curve of thoraco-laparoscopic esophagectomy, the initial results of MIE during learning curve is not favorable compared to open esophagectomy. Robotic surgical system has a potential to decrease learning period of MIE.

Robotic surgery is rapidly evolving in many areas of oncologic surgery. The future of robotic surgery in esophageal cancer is highly expected. We should wait for a lot of studies on RE to be reported in the future.
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