Implementation of robot-assisted Ivor Lewis procedure: Robotic hand-sewn, linear or circular technique?

Am J Surg. 2020 Jul;220(1):62-68. doi: 10.1016/j.amjsurg.2019.11.031. Epub 2019 Nov 26.

Abstract

Background: Robot-assisted surgery for esophageal cancer is increasingly applied. Despite this upsurge, the preferential technique to create a robot-assisted intrathoracic anastomosis has not been established.

Data sources: Bibliographic databases were searched to identify studies that performed a robot-assisted Ivor Lewis esophagectomy and described the technical details of the anastomotic technique. Out of 1701 articles, 16 studies were included for systematic review.

Conclusions: This review shows that all technique used to create a thoracoscopic anastomosis can be adopted to robotic surgery. Techniques can be divided into three categories: robotic hand-sewn, circular stapling or linear stapling and robotic hand-sewn closure of the stapler defect. With limited robotic experience, circular stapling might be the preferred technique, however requires a well-trained bedside assistant. The linear stapling technique or hand-sewn technique are more challenging but enable experienced robotic surgeons to perform a controlled anastomosis without bedside support.

Keywords: Anastomotic leakage; Esophagectomy; Intrathoracic anastomosis; Ivor lewis; Robotic.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anastomosis, Surgical / methods
  • Esophageal Neoplasms / surgery
  • Humans
  • Robotic Surgical Procedures / methods*
  • Surgical Stapling / methods*
  • Thoracoscopy / methods*