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Review
. 2025 Jan 28;32(2):72.
doi: 10.3390/curroncol32020072.

Evaluating Postoperative Morbidity and Outcomes of Robotic-Assisted Esophagectomy in Esophageal Cancer Treatment-A Comprehensive Review on Behalf of TROGSS (The Robotic Global Surgical Society) and EFISDS (European Federation International Society for Digestive Surgery) Joint Working Group

Yogesh Vashist  1 , Aman Goyal  2   3 , Preethi Shetty  4 , Sergii Girnyi  5 , Tomasz Cwalinski  5 , Jaroslaw Skokowski  5   6 , Silvia Malerba  5   6   7 , Francesco Paolo Prete  7 , Piotr Mocarski  5 , Magdalena Kamila Kania  5 , Maciej Świerblewski  5 , Marek Strzemski  8 , Luis Osvaldo Suárez-Carreón  9   10 , Johnn Henry Herrera Kok  11 , Natale Calomino  12 , Vikas Jain  13 , Karol Polom  6   14 , Witold Kycler  14 , Valentin Calu  15 , Pasquale Talento  16 , Antonio Brillantino  17 , Francesco Antonio Ciarleglio  18 , Luigi Brusciano  19 , Nicola Cillara  20 , Ruslan Duka  21 , Beniamino Pascotto  22 , Juan Santiago Azagra  22 , Mario Testini  7 , Adel Abou-Mrad  23 , Luigi Marano  5   6   12   21 , Rodolfo J Oviedo  24   25   26
Affiliations
Review

Evaluating Postoperative Morbidity and Outcomes of Robotic-Assisted Esophagectomy in Esophageal Cancer Treatment-A Comprehensive Review on Behalf of TROGSS (The Robotic Global Surgical Society) and EFISDS (European Federation International Society for Digestive Surgery) Joint Working Group

Yogesh Vashist et al. Curr Oncol. .

Abstract

Background: Esophageal cancer, the seventh most common malignancy globally, requires esophagectomy for curative treatment. However, esophagectomy is associated with high postoperative morbidity and mortality, highlighting the need for minimally invasive approaches. Robotic-assisted surgery has emerged as a promising alternative to traditional open and minimally invasive esophagectomy (MIE), offering potential benefits in improving clinical and oncological outcomes. This review aims to assess the postoperative morbidity and outcomes of robotic surgery.

Methods: A comprehensive review of the current literature was conducted, focusing on studies evaluating the role of robotic-assisted surgery in esophagectomy. Data were synthesized on the clinical outcomes, including postoperative complications, survival rates, and recovery time, as well as technological advancements in robotic surgery platforms. Studies comparing robotic-assisted esophagectomy with traditional approaches were analyzed to determine the potential advantages of robotic systems in improving surgical precision and patient outcomes.

Results: Robotic-assisted esophagectomy (RAMIE) has shown significant improvements in clinical outcomes compared to open surgery and MIE, including reduced postoperative pain, less blood loss, and faster recovery. RAMIE offers enhanced thoracic access, with fewer complications than thoracotomy. The RACE technique has improved patient recovery and reduced morbidity. Fluorescence-guided technologies, including near-infrared fluorescence (NIRF), have proven valuable for sentinel node biopsy, lymphatic mapping, and angiography, helping identify critical structures and minimizing complications like anastomotic leakage and chylothorax. Despite these benefits, challenges such as the high cost of robotic systems and limited long-term data hinder broader adoption. Hybrid approaches, combining robotic and open techniques, remain common in clinical practice.

Conclusions: Robotic-assisted esophagectomy offers promising advantages, including enhanced precision, reduced complications, and faster recovery, but challenges related to cost, accessibility, and evidence gaps must be addressed. The hybrid approach remains a valuable option in select clinical scenarios. Continued research, including large-scale randomized controlled trials, is necessary to further establish the role of robotic surgery as the standard treatment for resectable esophageal cancer.

Keywords: esophageal cancer; fluorescence-guided technologies; minimally invasive surgery; postoperative outcomes; robotic-assisted esophagectomy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Postoperative Advantages of Robotic-Assisted Esophagectomy for Better Patient Outcomes.
See this image and copyright information in PMC

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