Thorac Cardiovasc Surg
DOI: 10.1055/s-0040-1716323
Original Thoracic

Transcervical (SP) and Transhiatal DaVinci Robotic Esophagectomy: A Cadaveric Study

Pieter van der Sluis
1  Department of General-, Visceral- and Transplant Surgery, Universitaetsmedizin Mainz, Mainz, Germany
,
Jan-Hendrik Egberts
2  Department for General, Visceral-, Thoracic-, Transplantation-, and Pediatric Surgery, Kurt Semm Center for Minimal Invasive and Robotic Surgery, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
,
Hubert Stein
3  Intuitive Surgical Inc., Sunnyvale, California, United States
,
Rubens Sallum
4  Department of Gastroenterology, Digestive Surgery Division, Sao Paulo University, Sao Paulo, Brazil
,
Richard van Hillegersberg
5  Department of Gastrointestinal Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
,
1  Department of General-, Visceral- and Transplant Surgery, Universitaetsmedizin Mainz, Mainz, Germany
› Author Affiliations

Abstract

Background This is a preclinical cadaveric study to investigate the feasibility of a fully robotic McKeown esophagectomy in simultaneous rendezvous technique using the DaVinci X for transhiatal dissection and the DaVinci single port (SP) for transcervical dissection.

Methods Two transcervical esophagectomies with the DaVinci SP surgical system were performed as training procedures. In the third transcervical cadaveric procedure, the DaVinci SP was installed for the transcervical approach and the DaVinci X surgical system for the abdominal transhiatal phase. Primary outcomes were operating time and lymphadenectomy.

Results The mobilization of the esophagus was successfully completed in 118 minutes by using the DaVinci SP for the transcervical phase and the DaVinci X for the transhiatal abdominal phase simultaneously. In total 18 lymph nodes were dissected in the thorax; 3 were located paratracheal right, 3 paratracheal left, 4 subcarinal, 4 para-aortic, 2 paraesophageal upper mediastinal, and 2 paraesophageal middle mediastinal.

Conclusion This preclinical study demonstrated that a fully robotic McKeown esophagectomy in simultaneous rendezvous technique using the DaVinci X for transhiatal dissection and the DaVinci SP for transcervical dissection was feasible with adequate lymphadenectomy in a cadaver model. Future research will elucidate the indications for the use of the fully robotic transhiatal and transcervical esophagectomy.



Publication History

Received: 21 June 2020

Accepted: 13 July 2020

Publication Date:
08 September 2020 (online)

Georg Thieme Verlag KG
Stuttgart · New York