Application of full lateral decubitus position with cephalic parallel approach in robotic-assisted minimally invasive esophagectomy

Background: To overcome the technical shortcomings of robot-assisted minimally invasive esophagectomy (RAMIE), we designed an optimized approach called full lateral position with cephalic-parallel approach for this technique. Methods: We described and demonstrated the details regarding the full lateral position with cephalic-parallel approach for mobilization of the esophagus and mediastinal lymphadenectomy. On the basis of the location and T stage of esophageal cancer, a disease-specific resection process was also designed and introduced. Ten of our latest RAMIE procedures were performed using this approach. Perioperative data were collected and analyzed. Results: The mean duration of the entire RAMIE procedure was 381.0 +/- 57.5 min. Two (20%) patients suffered from postoperative hoarseness. The mean total number of lymph nodes dissected was 22.4 +/- 4.0, and the mean number of positive lymph nodes dissected was 2.0 +/- 2.7. Conclusions: The newly designed full lateral position with cephalic-parallel approach, which makes the procedure highly convenient, is technically feasible for RAMIE.