Robotic-assisted transhiatal esophagectomy

The optimal surgical procedure for the treatment of esophageal cancer continues toevolve. Traditionally, the options have long been limited to open esophagectomy using atransthoracic or transhiatal approach. These technically demanding operations are welldocumented to be effective in terms of good oncological control, although they are oftenassociated with significant morbidity and mortality rates. Since the first report by DePaula et al. in 1995, the efficacy of a laparoscopic approach for transhiatalesophagectomy has been proven in several papers. However, the clear advantages interms of less blood loss, reduced morbidity and shorter hospital stay could not overcomethe inherent boundaries of a laparoscopic approach. Due to these limitations, somesurgeons such as Luketich and later Nguyen abandoned the minimally invasivetranshiatal esophagectomy and switched to the combined thoracoscopic and laparoscopicapproach, although other inconveniences arose with this approach as well. The mostadvantageous procedure continued to remain elusive. The application of robotictechnology by Horgan et al. in 2001, offered a new perspective in the field of minimallyinvasive esophagectomy with transhiatal approach.