Robotic Ivor-Lewis Esophagectomy

Seyed A. Arshad, MD; Victor H. Phuoc, MD, FACS

Product Details
Product ID: ACS-5824
Year Produced: 2019
Length: 11 min.


Background: Esophageal cancer is the 8 most common malignancy in the world and the 6 most common cause of cancer associated mortality in the world. Surgical resection for curative intent can be performed by way of esophagectomy. Traditional methods for esophagectomy, such as open Ivor-Lewis esophagectomy, bear a high level of morbidity and mortality. Advances in minimally invasive techniques, including robotic assisted laparoscopy, have aided in less invasive operative approaches, decreasing the overall morbidity of these operations. Case Presentation: A 53 year-old male with a PMH of HTN and remote history of EtOH abuse presented with a 3 month history of dysphagia and was subsequently diagnosed with uT3NOMO distal esophageal adenocarcinoma. He underwent neoadjuvant chemoradiation with carboplatin and paclitaxel and subsequent PET/CT showed favorable response with no concerns for metastasis. The patient was then taken for a Robotic-assisted Ivor-Lewis Esophagectomy with curative intent. The patient did well post-operatively. He had a routine esophagram performed on post-operative day #1 showing no leak. He was initiated on enteral feeds via jejunostomy tube on post-operative day #2 and was able to be discharged on post-operative day #7. Pathology showed no residual adenocarcinoma with 0/27 nodes positive for metastasis. Discussion: Robotic assisted esophagectomy is a safe and technically feasible operation. It decreases the morbidity to patients undergoing these operations and allows for quicker post-operative recovery and earlier discharge.