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throughout the follow-up period the child has demonstrated evidence of ongoing neurologic improvement.This represents the youngest reported patient to be supported successfully to transplant with the PediMag pump. In addition, the PediMag was later used as posttransplant ECMO support in combination with the QUADROX-iD oxygenator. When using ¼-inch tubing connections with minimal length, the priming volume of the ECMO circuit is less than 160 mL, and the cannulas are readily available and easy to implant. Thrombotic complications continue to plague mechanical assistance in this age group, highlighting the importance of ongoing vigilance for areas of turbulence or stasis while the patient is receiving device support. In light of this, we endorse the use of coated tubing, connectors, and cannulas, and we prefer to limit the complexity of the circuit where possible. Relative to our previous mechanical circulatory assist experience in children 3 with the CentriMag (Thoratec Corporation, Pleasanton, Calif) at low flow, we have found the PediMag to be less prone to thrombus while being comparably easy to implant and use postoperatively.

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BackgroundWe have initially published our experience with the robotic transthoracic esophagectomy in 32 patients from a single institute. The present paper is the extension of our experience with robotic system and to best of our knowledge this represents the largest series of robotic transthoracic esophagectomy worldwide. The objective of this study was to investigate the feasibility of the robotic transthoracic esophagectomy for esophageal cancer in a series of patients from a single institute.MethodsA retrospective review of medical records was conducted for 83 esophageal cancer patients who underwent robotic esophagectomy at our institute from December 2009 to December 2012. All patients underwent a thorough clinical examination and pre-operative investigations. All patients underwent robotic esophageal mobilization. En-bloc dissection with lymphadenectomy was performed in all cases with preservation of Azygous vein. Relevant data were gathered from medical records.ResultsThe study population comprised of 50 men and 33 women with mean age of 59.18 years. The mean operative time was 204.94 mins (range 180 to 300). The mean blood loss was 86.75 ml (range 50 to 200). The mean number of lymph node yield was 18. 36 (range 13 to 24). None of the patient required conversion. The mean ICU stay and hospital stay was 1 day (range 1 to 3) and 10.37 days (range 10 to 13), respectively. A total of 16 (19.28%) complication were reported in these patents. Commonly reported complication included dysphagia, pleural effusion and anastomotic leak. No treatment related mortality was observed. After a median follow-up period of 10 months, 66 patients (79.52%) survived with disease free stage.ConclusionsWe found robot-assisted thoracoscopic esophagectomy feasible in cases of esophageal cancer. The procedure allowed precise en-bloc dissection with lymphadenectomy in mediastinum with reduced operative time, blood loss and complications.Electronic supplementary materialThe online version of this article (doi:10.1186/s12893-015-0024-2) contains supplementary material, which is available to authorized users.

Thoracoscopic esophagectomy is surgically safe and oncologically adequate. Thoracoscopy for patients in the left lateral position does not require prolonged single-lung ventilation. The anatomic orientation in the left lateral position is the same as that for open surgery, reducing the learning curve for thoracic surgeons. The potential advantages and the morbidity trend of prone instead of left lateral thoracoscopic esophagectomy needs to be evaluated.