Advances in minimally invasive esophagectomy (MIE): techniques, outcomes, and future directions

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Minimally invasive esophagectomy (MIE) has become a preferred surgical approach for treating esophageal cancer, offering significant advantages over traditional open surgery, such as reduced recovery times, fewer complications, and shorter hospital stays. This review highlights advancements in MIE techniques, with a focus on the growing role of robotic-assisted MIE (RAMIE) in enhancing surgical precision and patient outcomes. Recent trials, such as REVATE and ROBOT-2, highlight RAMIE’s advantages in lymph node resection and reduction in nerve injury rates, suggesting its potential to improve both short- and long-term outcomes. Further innovations, including artificial intelligence (AI) and telementoring, are enhancing surgical navigation and procedural safety, making MIE more accessible globally. Despite these advances, challenges remain, particularly regarding the steep learning curve. This review examines the evolution of MIE techniques, their clinical outcomes, and the future role of emerging technologies in optimizing esophageal cancer surgery.

This review highlights that minimally invasive and robotic-assisted esophagectomy techniques improve perioperative outcomes and reduce pulmonary complications compared to open surgery for esophageal cancer.