Minimally invasive esophagectomy

Abstract

Background Minimally invasive techniques have replaced the conventional open approach in many operations. For esophagectomy, it took quite a long time to become routine even in centers. The aim of this review was to demonstrate history and current status of minimally invasive esophagectomy and also robotic-assisted esophagectomy with its associated techniques. Methods Selected literature on minimally invasive surgery for esophageal cancer was identified using a PubMed search for the period 1990-2018 with the search terms esophagectomy, minimal invasive, robotic, indocyanine fluorescein, enhanced recovery after surgery (ERAS), fast-track, nerve monitoring and its permutations. Results Within the last two decades minimally invasive esophagectomy has found its way into clinical practice. It reduces perioperative morbidity with equivalent oncological outcome. It allows for better pulmonary results, less blood loss, less pain, and better quality of life. If robotic assisted esophagectomy helps to further improve the results is currently under investigation. Fast-track protocols have proven their value. Intraoperative nerve monitoring and indocyanine green fluorescein imaging of the perfusion of the gastric tube can lower perioperative complications. Conclusions Minimally invasive surgery for esophageal malignancies offers advantages when performed in an environment with sufficient expertise and caseload. Whether robotic-assisted minimally invasive esophagectomy further improves the results

A study to assess post operative complications of hybrid approach with video assisted thoracoscopic surgery in locally advanced carcinoma oesophagus

“…The operative technique depends on tumour location, surgeon preference and availability of resources. 6 Oesophageal cancer surgery can be done in open or minimally invasive methods and a combination of both (hybrid procedures).…”

“…7 The minimally invasive surgery for the oesophagus can be; The VATS oesophagectomy was initially described in the supine position, later changed to a lateral, prone and now semiprone position. 6,8 The advantages of minimally invasive surgery for oesophageal cancer are less morbidity, including pulmonary complications, cardiac complications, less intraoperative blood loss, less pain and lesser hospital and intensive care.…”

Effect of prophylactic central neck dissection following total thyroidectomy on surgical site wound infection, hematoma, and haemorrhage in subjects with clinically node‐negative papillary thyroid carcinoma: A meta‐analysis

“…Also, for low‐risk subjects, we agreed that ipsilateral prophylactic central neck dissection plus frozen section might be appropriate and might avoid the high illness rate, 42 although this hypothesis requests more supportive statistical data. With the application and extension of the harmonic scalpel, 45 continuous monitoring of the recurrent laryngeal nerve, 46 and enhancements in surgical skills, we consider the advantages of prophylactic central neck dissection and total thyroidectomy might be more significant in the long term. However, not much in most of the previous meta‐analysis was given to surgical site wound infection, hematoma, and haemorrhage.…”