Esophageal Cancer Surgery

Robotic Esophagectomy in the Prone Position


Esophagectomy with total mediastinal lymphadenectomy with or without cervical lymphadenectomy remains the main option for the curative treatment of esophageal squamous cell carcinoma. However, meticulous mediastinal lymph node dissection frequently induces recurrent laryngeal nerve palsy (RLNP), leading to postoperative laryngopharyngeal dysfunction. Surgical robots have been developed to overcome some of the disadvantages of standard minimally invasive surgery and facilitate precise dissection in a confined surgical field with impressive dexterity. We have been using the surgical robot, da Vinci S HD Surgical System, in the thoracic phase of esophagectomy since 2009. To date, we have performed approximately 30 cases of robotic esophagectomy and have demonstrated the possibility that the use of the robotic system in thoracoscopic esophagectomy in the prone position might reduce postoperative laryngopharyngeal dysfunction related to RLNP. In this chapter, we present updates on the methods and short-term outcomes of robotic esophagectomy based on our experience and review of the literatures.


Esophageal Squamous Cell Carcinoma Bronchial Artery Thoracic Esophagus Recurrent Laryngeal Nerve Palsy Azygos Vein 
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Intercostal space


The 1st arm


The 2nd arm


The 3rd arm


Recurrent laryngeal nerve


Recurrent laryngeal nerve palsy



This work was not supported by any grants and fundings. No author has commercial association with or financial involvement that might pose a conflict of interest in connection with the submitted article.


  1. 1.
    Eslick GD (2009) Epidemiology of esophageal cancer. Gastroenterol Clin North Am 38:17–25PubMedCrossRefGoogle Scholar
  2. 2.
    Fujita H, Sueyoshi S, Tanaka T et al (2002) Three-field dissection for squamous cell carcinoma in the thoracic esophagus. Ann Thorac Cardiovasc Surg 8:328–335PubMedGoogle Scholar
  3. 3.
    Fumagalli U (1996) Panel of experts. Resective surgery for cancer of the thoracic esophagus: results of a consensus conference held at the 6th world congress of the international society for diseases of the Esophagus. Dis Esophagus 9(suppl):30–38Google Scholar
  4. 4.
    Suda K, Ishida Y, Kawamura Y, Inaba K, Kanaya S, Teramukai S, Satoh S, Uyama I (2012) Robot-assisted thoracoscopic lymphadenectomy along the left recurrent laryngeal nerve for esophageal squamous cell carcinoma in the prone position: technical report and short-term outcomes. World J Surg 36:1608–1616PubMedCrossRefGoogle Scholar
  5. 5.
    Noshiro H, Iwasaki H, Kobayashi K et al (2010) Lymphadenectomy along the left recurrent laryngeal nerve by a minimally invasive esophagectomy in the prone position for thoracic esophageal cancer. Surg Endosc 24:2965–2973PubMedCrossRefGoogle Scholar
  6. 6.
    Uyama I, Suda K, Satoh S (2013) Laparoscopic surgery for advanced gastric cancer: current status and future perspectives. J Gastric Cancer, 13:19–25Google Scholar
  7. 7.
    Japanese Esophageal Society (2008) Japanese classification of esophageal cancer, the 10th edn. revised version, Kanehara Shuppan, TokyoGoogle Scholar

Copyright information

© Springer Japan 2014

Authors and Affiliations

  1. 1.Division of Upper GI, Department of SurgeryFujita Health UniversityToyoakeJapan

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