Early diagnostic endoscopy and prophylactic stenting after robotic transthoracic esophagectomy - From scepticism to standardization.

Dehiscence following esophagectomy for cancer has a mortality rate of 10-40%, prolongs hospital stay, and reduces survival. To prevent it, proper patient selection and surgical techniques that minimize tension and ischemia are essential. Procedures such as ERAS protocols and the use of indocyanine green have improved the detection of well-vascularized areas, but the leak rate still exceeds 10%.

Absence of thoracotomy by intrathoracic manual suture and transabdominal removal of surgical specimen during Ivor Lewis robotic esophagectomy.

In the surgical treatment of esophageal cancer, robotic surgery allows performing an intrathoracic handsewn anastomosis in a simpler, faster and more comfortable way for the surgeon than open surgery and traditional minimally invasive surgery. With this, we avoid the use of self-suture instruments, some of which require a small thoracotomy for their introduction. However, the retrieval of the specimen requires the practice of this thoracotomy, of variable size, that can be associated with intense chest pain.