Implementation of robot-assisted Ivor Lewis procedure: Robotic hand-sewn, linear or circular technique?

Victor D. Plat, Wessel T. Stam, Linda J. Schoonmade, David J. Heineman, Donald L. van der Peet, Freek Daams

Research output: Contribution to journalReview articleAcademicpeer-review

19 Citations (Scopus)


Background: Robot-assisted surgery for esophageal cancer is increasingly applied. Despite this upsurge, the preferential technique to create a robot-assisted intrathoracic anastomosis has not been established. Data sources: Bibliographic databases were searched to identify studies that performed a robot-assisted Ivor Lewis esophagectomy and described the technical details of the anastomotic technique. Out of 1701 articles, 16 studies were included for systematic review. Conclusions: This review shows that all technique used to create a thoracoscopic anastomosis can be adopted to robotic surgery. Techniques can be divided into three categories: robotic hand-sewn, circular stapling or linear stapling and robotic hand-sewn closure of the stapler defect. With limited robotic experience, circular stapling might be the preferred technique, however requires a well-trained bedside assistant. The linear stapling technique or hand-sewn technique are more challenging but enable experienced robotic surgeons to perform a controlled anastomosis without bedside support.
Original languageEnglish
Pages (from-to)62-68
Number of pages7
JournalAmerican Journal of Surgery
Issue number1
Early online date26 Nov 2019
Publication statusPublished - 1 Jul 2020


  • Anastomotic leakage
  • Esophagectomy
  • Intrathoracic anastomosis
  • Ivor lewis
  • Robotic

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