title: Robotic-assisted esophagoesophagostomy.
abstract: OBJECTIVE
  Minimally invasive repair of esophageal atresia has been described but remains technically challenging. Robotic surgical systems address many of these technical challenges. The purpose of this study was to develop the procedure for and evaluate the technical feasibility of performing a robotic-assisted esophagoesophagostomy using the Zeus Robotic Surgical System.
  
  
  METHODS
  Esophagoesophagostomy was performed in 10 piglets using thoracoscopic (control, n = 5) and robotic-assisted (Zeus, experimental, n = 5) approaches. An interrupted esophageal anastomosis using intracorporeal knot tying techniques was performed and evaluated for leak, narrowing, caliber, and mucosal approximation. Anesthesia, operative, anastomotic, and robotic set-up times were recorded as was the number of stitches used.
  
  
  RESULTS
  All 10 anastomoses were patent with no narrowing and with excellent mucosal approximation. One anastomosis in the control group had a small leak. There was no statistically significant difference between the groups for the parameters measured. Weight (kg): control (C), 6.4 +/- 0.8; experimental (E), 6.3 +/- 1.0, P =.08. Times (min): anesthesia, C-124 +/- 25, E-151 +/- 20, P =.09; operative, C-97 +/- 21, E-131 +/- 27, P =.06; anastomotic, C-89 +/- 20, E-125 +/- 34, P =.08; robotic set-up, C-6.4 +/- 9.3, E-15.6 +/- 20, P = 0.13. Stitches (No.): C-11.8 +/- 0.8, E-12.0 +/- 1.2, P =.7. Caliber (French):C-18F-5; E-18F-4, 14F-1.
  
  
  CONCLUSIONS
  Robotic-assisted esophagoesophagostomy is technically feasible and offers an alternative approach to thoracoscopic repair of esophageal atresia.
authors.affiliation: Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA 71130, USA.
authors.forename: Celeste M
authors.initials: CM
authors.lastname: Hollands
authors.forename: Laramie N
authors.initials: LN
authors.lastname: Dixey
mesh_terms: D000714:Anastomosis, Surgical; D000818:Animals; D004933:Esophageal Atresia / Q000601:surgery; D004946:Esophagostomy / Q000379:methods*; D005240:Feasibility Studies; D012371:Robotics / Q000379:methods*; D013536:Suture Techniques; D013552:Swine