Initial results of robot-assisted Ivor-Lewis oesophagectomy with intrathoracic hand-sewn anastomosis in the prone position

Background There is scanty experience concerning robot‐assisted Ivor–Lewis oesophagectomy, so every new experience is helpful. Methods We describe the techniques and short‐term results of Ivor–Lewis oesophagectomy using a laparoscopic approach and robot‐assisted thoracoscopy, and an observational study of prospective surveillance of the first 14 patients treated for oesophageal cancer. A gastric tube was created laparoscopically. Oesophagectomy was performed through a robot‐assisted thoracoscopy followed by hand‐sewn intrathoracic anastomosis. Results There were no conversion cases. Mortality was zero. Six patients had a major complication. There were no cases of respiratory complication or recurrent laryngeal nerve palsy. Three patients had a radiological fistula (21.4%), successfully treated by endoscopic stenting, and one (7.1%) had an anastomosis leak needing reoperation. There were two cases of chylothorax (14.3%). Conclusions Our initial results suggest that the reported technique is safe and satisfies the oncological principles. It provides the advantages of minimally invasive surgery by overcoming some limitations of conventional thoracoscopy. Copyright © 2014 John Wiley & Sons, Ltd.