title: Robotic fourth-arm enucleation of an esophageal leiomyoma and review of literature.
abstract: Esophageal leiomyomas are resected in symptomatic and/or malignancy-suspicious cases. Traditionally, they have been removed by laparotomy or thoracotomy and more recently by thoracoscopy and laparoscopy. Mucosal injury is reported as high as 7% of cases but may be higher in unreported general practice. Robotic technology seems to offer advantages. We describe a robotic approach that seems to minimize mobilization of the esophagus, potentially decreasing the likelihood of mucosal injury and postoperative recovery time. We review the literature to evaluate the reports of mucosal injury with the open, minimally invasive, and robotic techniques and describe our own method. To improve efficiency, we use a four-arm technique.
authors.affiliation: From the Department of Thoracic Surgery, City of Hope National Medical Center, Duarte, CA USA.
authors.forename: Kemp H
authors.initials: KH
authors.lastname: Kernstine
authors.forename: Emily S
authors.initials: ES
authors.lastname: Andersen
authors.forename: Andres
authors.initials: A
authors.lastname: Falabella
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Ramirez
authors.forename: Casandra A
authors.initials: CA
authors.lastname: Anderson
authors.forename: Ihab
authors.initials: I
authors.lastname: Beblawi