Roboterassistierte minimal-invasive Ösophagektomie: Kurative Präzisionschirurgie bei ösophagealem Plattenepithelkarzinom

Background: Robotic surgery represents the latest development in the curative minimally invasive treatment of esophageal squamous cell carcinoma. Objectives: Presented are epidemiology, curative treatment, advantages of minimally invasive and robotic surgery, and introduction of robotic-assisted esophagectomy. Materials and methods: Based on a review of the literature, the technique of robot-assisted minimally invasive esophagectomy (RAMIE) is demonstrated. Results: Esophageal squamous cell carcinoma still represents—despite an increase of esophageal adenocarcinoma especially in the Western world—the predominant malignancy of the esophagus worldwide and in Germany. Surgery plays a key role in treatment with curative intent. On the basis of prospective randomized controlled trials that demonstrate distinct advantages of minimally invasive surgery over open approaches—especially with regard to pulmonary complications—minimally invasive surgery is regarded the gold standard for treatment of esophageal squamous cell carcinoma and is employed in experienced centers worldwide. Robotic surgery represents the latest development in this field and combines the advantages of minimally invasive surgery with increased degrees of freedom in the movement of instruments as in open surgery. Finally, the technique robotic-assisted minimally invasive esophagectomy is presented. Conclusions: Robot-assisted minimally invasive esophagectomy represents a new level of precision surgery that combines the advantages of minimally invasive and open approaches.