Robotic-Assisted Esophagectomy

At Siteman Cancer Center, patients may have the option to undergo an esophagectomy conducted through robotic technology. An esophagectomy is a procedure to remove some or all of the esophagus. Robotic assistance allows the surgeon to conduct the operation minimally invasively: the instruments are inserted into the body through a number of small incisions, rather than a single large one. Consequently, patients tend to recover more quickly and with less pain. Your surgeon will let you know if you are a good candidate for a robotic-assisted esophagectomy.

Undergoing a “robotic-assisted esophagectomy” doesn’t mean that a robot performs your operation. Your surgeon is in charge the entire time. The robot is actually a system of four mechanical arms that have the same degree of flexibility as the human hand. These arms hold surgical instruments and a camera, allowing the surgeon to look inside the body and perform the surgery in a confined space.

How does the procedure work?

During a robotic-assisted esophagectomy, the surgeon makes several small incisions in the patient’s chest, rather than one large incision. The incisions are usually less than an inch long, although one may be slightly bigger. The robotic arms are guided into these incisions.

Then, the surgeon sits down at a special console in the operating room. The console is equipped with a screen and controls shaped like actual surgical instruments. Using a camera, the robotic arms transmit 3-D images from inside the body to the screen, so the surgeon can zoom in on tiny features of organs and tissues with far greater accuracy than the human eye. This enhanced visibility lowers the risk of complications.

The robotic arms can move as flexibly as the human hand and wrist, and the surgeon manipulates them from the console by moving the controls.

There are a number of other medical professionals in the operating room in addition to the lead surgeon. A second surgeon stands at the patient’s bedside, monitoring the patient and assisting the lead surgeon. The room is also staffed with trained operating room nurses, as well as a nurse who specializes in working with robotic technology.

After the surgery, patients tend to recover more quickly because they don’t have any major incisions that need to heal.

What are the benefits of a robotic-assisted esophagectomy?

A robotic-assisted esophagectomy is easier on the patient’s body than a traditional, open procedure. This means that patients will probably

• Leave the hospital sooner
• Experience less pain
• Lose less blood
• Have a lower risk of complications
• Return to normal activities faster

What patients are good candidates for the procedure?

Patients tend to be eligible for a robotic-assisted esophagectomy if they have not had previous abdominal or thoracic (chest) surgery. Some larger tumors that may be attached to nearby structures are more safely removed with open procedures.

What are the risks of a robotic-assisted esophagectomy?

Robotic-assisted esophagectomies tend to pose less risk to patients than traditional, open esophagectomies. However, complications can still arise, including:

• Blood loss
• Infection
• Trouble breathing
• A leak in the connection between the stomach and the esophagus, also known as an anastomotic leak

Why should I choose Siteman for a robotic-assisted esophagectomy?

Robots are only as good as the surgeons controlling them. The esophageal surgeons at Siteman are nationally-renowned for their skill, innovation, and training. We usually perform more than 50 open esophagectomies per year, and, as a high volume program, have the experience and the support staff to provide the care you deserve.