Thorac Cardiovasc Surg 2019; 67(07): 610-614
DOI: 10.1055/s-0039-1685471
How to Do It
Georg Thieme Verlag KG Stuttgart · New York

Robot-Assisted McKeown Procedure via a Cervical Mediastinoscopy Avoiding an Abdominal and Thoracic Incision

Jan-Hendrik Egberts
1   Department for General, Visceral-, Thoracic-, Transplantation-, and Pediatric Surgery, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
,
Mark Schlemminger
1   Department for General, Visceral-, Thoracic-, Transplantation-, and Pediatric Surgery, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
,
Charlotte Hauser
1   Department for General, Visceral-, Thoracic-, Transplantation-, and Pediatric Surgery, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
,
Thomas Becker
1   Department for General, Visceral-, Thoracic-, Transplantation-, and Pediatric Surgery, University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany
› Author Affiliations
Further Information

Publication History

11 November 2018

04 March 2019

Publication Date:
30 April 2019 (online)

Abstract

Total esophagectomy for esophageal cancer is associated with high morbidity. The avoidance of a thoracic access could especially reduce the occurrence of pulmonary complications. Therefore, the combination of a high transhiatal dissection of the esophagus and a neck access with mediastinal dissection of the esophagus appears to be a possibility to reduce the pulmonary risks. However, the access to the posterior mediastinum is very limited with the conventional minimal invasive instruments. These limitations can be overcome by the use of a surgical robot.

In this article, we present a novel operation technique for a complete robot-assisted (da Vinci Xi) McKeown procedure avoiding a thoracic approach and abdominal incision by using a rendezvous technique with an abdominal and cervical docking of the robot system.

Informed Consent

Written informed consent was obtained from patient for publication of this report and any associated images and videos.


 
  • References

  • 1 Watanabe M, Yoshida N, Karashima R. , et al. Transcervical superior mediastinal lymph node dissection combined with transhiatal lower esophageal dissection before transthoracic esophagectomy: a safe approach for salvage esophagectomy. J Am Coll Surg 2009; 208 (04) e7-e9
  • 2 Fujiwara H, Shiozaki A, Konishi H. , et al. Single-port mediastinoscopic lymphadenectomy along the left recurrent laryngeal nerve. Ann Thorac Surg 2015; 100 (03) 1115-1117
  • 3 Egberts JH, Stein H, Aselmann H, Hendricks A, Becker T. Fully robotic da Vinci Ivor-Lewis esophagectomy in four-arm technique-problems and solutions. Dis Esophagus 2017; 30 (12) 1-9