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Purpose <p>Minimally invasive esophagectomy (MIE) is the standard surgical procedure. Robot-assisted MIE (RAMIE) was developed to overcome the problems associated with conventional MIE. This study investigated whether or not standardizing surgical procedures for RAMIE using soft coagulation scissors and Maryland bipolar forceps could improve short-term outcomes.</p> Methods <p>This study included 130 patients who underwent RAMIE. Clinicopathological characteristics and surgical outcomes were compared before and after standardization by two expert surgeons as well as between the standardized and trainee groups. A cumulative sum control chart (CUSUM) was used to evaluate changes in operative time.</p> Results <p>The console time during the thoracic procedure was shorter in the standardized group than in the pre-standardized group (<i>P</i> &lt; 0.001). The rate of recurrent laryngeal nerve palsy was lower in the standardized group than in the pre-standardized group (<i>P</i> = 0.039). No significant differences were observed between the standardized and trainee groups. In the standardized and trainee groups, CUSUM clearly indicated that the console time peak occurred in the 12th and 16th cases.</p> Conclusions <p>Standardization of surgical procedures using an appropriate device for each surgical step could improve surgical outcomes in RAMIE. Furthermore, it may facilitate safer and more efficient surgical training.</p>

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Standardization using soft coagulation scissors and Maryland bipolar forceps techniques reduces the operative time and incidence of recurrent laryngeal nerve palsy in robot-assisted minimally invasive esophagectomy

  • 期刊论文

  • 发表日期：

    2025年11月20日

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  • Hironobu Goto,
  • Yasufumi Koterazawa,
  • Tomoaki Aoki,
  • Yutaka Sugita,
  • Taro Ikeda,
  • Hitoshi Harada,
  • Yasunori Otowa,
  • Naoki Urakawa,
  • Hiroshi Hasegawa,
  • Shingo Kanaji,
  • Takeru Matsuda,
  • Taro Oshikiri,
  • Yoshihiro Kakeji

摘要

Purpose

Minimally invasive esophagectomy (MIE) is the standard surgical procedure. Robot-assisted MIE (RAMIE) was developed to overcome the problems associated with conventional MIE. This study investigated whether or not standardizing surgical procedures for RAMIE using soft coagulation scissors and Maryland bipolar forceps could improve short-term outcomes.

Methods

This study included 130 patients who underwent RAMIE. Clinicopathological characteristics and surgical outcomes were compared before and after standardization by two expert surgeons as well as between the standardized and trainee groups. A cumulative sum control chart (CUSUM) was used to evaluate changes in operative time.

Results

The console time during the thoracic procedure was shorter in the standardized group than in the pre-standardized group (P < 0.001). The rate of recurrent laryngeal nerve palsy was lower in the standardized group than in the pre-standardized group (P = 0.039). No significant differences were observed between the standardized and trainee groups. In the standardized and trainee groups, CUSUM clearly indicated that the console time peak occurred in the 12th and 16th cases.

Conclusions

Standardization of surgical procedures using an appropriate device for each surgical step could improve surgical outcomes in RAMIE. Furthermore, it may facilitate safer and more efficient surgical training.