ABSTRACT
Esophagectomy is a surgical operation which requires technical expertise to decrease the morbidity and mortality frequently associated with this advance procedure. Various minimally invasive esophagectomy techniques have been developed to decrease the negative impact of esophageal resection. Recently, robotic assisted esophagectomies have been described with a wide variety in technique and outcome disparity. This article is a summation review of the current literature regarding the various techniques and surgical outcomes of robotic assisted esophagectomies.
Subject(s)
Esophagectomy/methods , Laparoscopy/methods , Robotics/methods , Adenocarcinoma/surgery , Carcinoma, Squamous Cell/surgery , Clinical Trials as Topic/statistics & numerical data , Cost Control , Esophageal Neoplasms/surgery , Esophagectomy/economics , Esophagectomy/instrumentation , Esophagectomy/trends , Esophagoplasty/economics , Esophagoplasty/instrumentation , Esophagoplasty/methods , Follow-Up Studies , Humans , Laparoscopy/economics , Laparoscopy/trends , Lymph Node Excision/methods , Meta-Analysis as Topic , Postoperative Complications/epidemiology , Robotics/economics , Robotics/instrumentation , Robotics/trends , Time Factors , Treatment OutcomeABSTRACT
Esophagectomy is a complex operation with significant morbidity and mortality. Minimally invasive esophagectomy (MIE) was described in the 1990s in an effort to reduce operative morbidity. Since then many institutions have adopted and described their series with this technique. This paper reviews the literature on the variety of MIE techniques, clinical and quality of life outcomes with open versus MIE, and controversies surrounding MIE-such as prone positioning, stapling techniques, size of the gastric conduit, and robotic techniques.
ABSTRACT
Obesity among adults, children and adolescents has markedly increased regardless of gender, age, ethnicity or educational level, and has become a national health threat and a major public health challenge. This obesity epidemic can be attributed to excess energy intake and decreased energy expenditure experienced in Westernized countries. Unfortunately, there is no single solution to prevent or treat obesity that will be inclusive of everyone. Often times, treatment of obesity may include a combination of diet, exercise, behavior modification, medication, and sometimes weight-loss surgeries. Hence, bariatric surgery has evolved over the last four decades and has been shown to be effective in reducing obesity related comorbidities, improve the quality of life, number of sick days, monthly medication costs, and overall mortality. With the increasing rates of weight loss surgical procedures, the quality, efficacy and surgical outcomes have improved with the creation of Bariatric Centers of Excellence designated by the American Society of Metabolic and Bariatric Surgery or American College of Surgeons. The benefits of bariatric procedures in morbidly obese patients outweigh the risks. With the advent of minimally invasive surgical procedures, bariatric surgery is a reasonable treatment option in those who strongly desire substantial weight loss and have life-threatening comorbid conditions.
