Publication

Abstract : Esophageal cancers have become the leading cause of cancer-related deaths in the Indian population. Minimally invasive esophagectomy (MIE) after neoadjuvant chemoradiotherapy has become the standard of care for malignancy of the esophagus. The decreased peri-operative complications, post-operative critical care stay, and improved patient outcomes have proven the superiority of MIE. Furthermore, R0 resection and better lymph node retrieval, especially around the recurrent laryngeal area, with MIE help in improved staging of the disease, which translates into better survival. Nowadays, both the thoracoscopic and robotic approaches are the standard of care, and both have certain advantages and disadvantages. The decision between a robotic and thoracoscopic approach depends on the availability of expertise and facilities. Overall, the highlights of robotic-assisted esophagectomy are an increased lymph-nodal yield compared to thoracoscopic esophagectomy with equivalent peri-operative complications and an added advantage of a shorter learning curve and comfortable ergonomics for the operating surgeon. This chapter highlights the technical details of both thoracoscopic and robotic approaches for esophagectomy with two-field lymphadenectomy. It will also provide comprehensive details about the post-operative complications and survival rate post-esophagectomy.