Background: Robotic surgery has been shown to improve the perioperative course and potentially
also the tumor-associated overall survival in esophageal cancer, as compared to open
conventional esophagectomy (OE)
Aims: Here, we compared the perioperative outcomes of robot-assisted (RAMIE, DaVinci Xi)
vs. open conventional esophagectomy in a high-volume university hospital.
Methods: We prospectively collected numeric data on surgery-related technical details of all
our upper GI robotic cases in the study period
Results: Between April 2022-November 2024, we compared the outcome of RAMIE (n=42) with open
conventional Ivor-Lewis esophagectomy / OE (n=144) from our institution. The most
common diagnosis was AEG Siewert type II (n=36 for RAMIE, n=111 for OE), followed
by squamous cell cancer (n=6 for RAMIE vs. n=33 for OE). The median operating time
was significantly shorter for OE when compared to RAMIE (152 min. vs. 290 min.), whereas
the median hospital stay was comparable (16d for OE vs. 19.2 d for RAMIE). The anastomotic
leak rate tended to be higher in the RAMIE group, yet with no statistical significance
(13/42=30% vs. 25/144=17.3%). There was no difference in the rate of Clavien-Dindo
grade 0-2 or 3-4 complications. Similarly, the in-hospital mortality (3/144 for OE=2.1%
vs. 2/42=4.8% for RAMIE) and re-admission rate was similar (18% for OE vs. 11.9% for
RAMIE).
Conclusions: RAMIE offers comparable perioperative results as OE in centers that have long-standing
experience in OE. The longer median operative times of RAMIE were in this series not
counterbalanced / compensated by any difference in the complication rates or morbidity.
