title: Robot-Assisted Minimally Invasive Ivor Lewis Esophagectomy With Real-Time Perfusion Assessment.
abstract: BACKGROUND
  Surgical resection is viewed as the most effective way to ensure both locoregional control and long-term survival in esophageal cancer. Although minimally invasive esophagectomy has been widely accepted as an alternative to open surgery, the role of robotic assistance has yet to be elucidated. We report our institutional experience with robotic-assisted Ivor Lewis esophagectomy using real-time perfusion assessment and demonstrate this as a safe and technically feasible alternative to traditional open Ivor Lewis esophagectomy.
  
  
  METHODS
  A retrospective chart review of all patients undergoing robotic-assisted Ivor Lewis esophagectomy at a single institution from 2011 to 2014 was performed. Operative and postoperative outcomes were recorded.
  
  
  RESULTS
  Fifty-four patients underwent robotic-assisted Ivor Lewis esophagectomy during the study period. Indication for surgery was cancer in 49 patients, 38 of whom underwent neoadjuvant chemoradiation therapy. The average operative time was 6 hours 2 minutes, and the average blood loss was 74 mL. There was 1 postoperative mortality (1.9%). Three (5.5%) patients experienced an anastomotic leak. The average number of lymph nodes harvested in cancer patients was 16.2 (range, 3 to 35). The average length of stay was 12.9 days.
  
  
  CONCLUSIONS
  Our study demonstrates that robotic-assisted Ivor Lewis esophagectomy using real-time perfusion assessment is a safe and technically feasible alternative to traditional open Ivor Lewis esophagectomy. It allows for R0 resection with adequate lymph node harvesting and a short hospital stay.
authors.affiliation: Department of General Surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Arielle
authors.initials: A
authors.lastname: Hodari
authors.affiliation: Department of General Surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Ko Un
authors.initials: KU
authors.lastname: Park
authors.affiliation: Department of General Surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Brian
authors.initials: B
authors.lastname: Lace
authors.affiliation: Department of General Surgery, Henry Ford Hospital, Detroit, Michigan.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Tsiouris
authors.affiliation: Division of Thoracic Surgery, Henry Ford Hospital, Detroit, Michigan. Electronic address: zhammou1@hfhs.org.
authors.forename: Zane
authors.initials: Z
authors.lastname: Hammoud
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003199:Computer Systems; D016629:Esophagectomy / Q000379:methods*; D004947:Esophagus / Q000098:blood supply; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D016343:Monitoring, Intraoperative / Q000379:methods; D012039:Regional Blood Flow; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures