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Supplement: The Minimally Invasive Thoracic Surgery Summit

Robotic Esophagectomy: Is It an Advance and What is the Future?

Division of Thoracic and Foregut Surgery, Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York

^_* Address correspondence to Dr Watson, Division of Thoracic and Foregut Surgery, Department of Surgery, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Box Surgery, Rochester, NY 14642 (Email: thomas_watson@urmc.rochester.edu).

Presented at the Minimally Invasive Thoracic Surgery Summit, New York, NY, June 8–9, 2007.

The first 300 words of the full text of this article appear below.

	Introduction

 
Surgical robotics have been increasingly used in the past several years to assist in a variety of operations. Some applications, such as in prostatectomy, have been widely adopted and have largely supplanted the alternative minimally invasive or open techniques. The use of surgical robots in other procedures, although apparently safe and feasible, has not been as common. Robotic-assisted esophagectomy is one such procedure.

Although a limited number of case reports and small case series have demonstrated the feasibility of robotic esophagectomy, no large series of patients undergoing such operations has been reported to date. Data regarding successful completion rates for the procedure, operative times, lengths of stay, intraoperative complications, morbidity, mortality, and costs are limited. In addition, no data have been reported on medium- or long-term results regarding cure rates for esophageal cancer or functional outcomes. This report reviews the available literature about robotic esophagectomy and highlights issues pertinent to the eventual adoption or rejection of the technology for this specific indication. In this article, robotic esophagectomy refers specifically to esophagectomy completed with the assistance of the da Vinci Surgical System (Intuitive Surgical Inc, Sunnyvale, CA).

	Potential Advantages of Robotic Esophagectomy

 
Relative to traditional minimally invasive surgical procedures using standard instrumentation and visualization, robotic-assisted surgery possesses several potential advantages. The da Vinci Surgical System allows increased magnification with three-dimensional imaging. Current systems are available in high definition, although similar systems are penetrating the market for standard laparoscopy and thoracoscopy. The robotic arms allow improved dexterity and articulation relative to standard, rigid, minimally invasive instrumentation. Seven degrees of motion are afforded by the robotic system:

1 in/out,

2 rotation,

3 pitch at wrist,

4 yaw at wrist,

5 pitch at fulcrum,

6 yaw at fulcrum, and

7 grip strength.

In addition, the robotic arms allow for improved motion stability with tremor filtration and motion scaling, potentially . . . [Full Text of this Article]