The Usefulness of Robot-Assisted Minimally Invasive Esophagectomy

Abstract Background Robot-Assisted Minimally Invasive Esophagectomy (RAMIE) has the significant advantage of enabling the use of articulated forceps without hand tremor, and our hospital has so far performed 320 cases. By comparing and examining the treatment outcomes of RAMIE and conventional MIE, we will clarify the usefulness of RAMIE and present our hospital’s surgical techniques for RAMIE. Methods We retrospectively examined 484 cases (RAMIE: 223 cases/MIE: 261 cases) of thoracoscopic surgery for esophageal cancer, excluding cases of recurrent nerve combined resection, out of 664 cases of thoracoscopic surgery for esophageal cancer performed from April 2020 to June 2024. We adjusted the background using propensity score matching with age, sex, localization, ASA-PS, cT, cN, cM, and preoperative treatment as covariates, and compared the short-term outcomes. Results 204 cases were extracted for each of the RAMIE and MIE groups, and there were no significant differences in background factors. In terms of short-term outcomes, RAMIE was significantly longer than MIE in terms of thoracic surgery time (200 min/185 min, p 0.01). the amount of bleeding was significantly lower in RAMIE at 123 mL/173 mL (p 0.01). The incidence of recurrent nerve paralysis of CD1 or higher tended to be lower in RAMIE at 13.7%/20.1% (p = 0.113), suture failure in CD2 or higher was 3.4%/8.3% (p = 0.056), and pneumonia was 6.9%/15.7% (p 0.01), which were lower in RAMIE. Conclusion RAMIE tended to have a longer operating time than MIE, but the short-term results were good, suggesting that RAMIE is a useful technique.