with Dr. Antonio M. Lacy
Dr. Antonio M. de Lacy (Spain) and his team at the Hospital Clinic of Barcelona will perform a Robotically assisted Ivor-Lewis esophagectomy and answer all your questions.
Clinical History:
Clinical Background
A 79-year-old man diagnosed with a neoplasm of the distal third of the esophagus, stage uT2N1. He received neoadjuvant treatment with chemoradiation, with complete metabolic response in the restaging PET-CT scan.
Histology: moderately differentiated ADK.
Neoadjuvant treatment received: CROSS protocol (carboplatin/paclitaxel + 41.4Gy).
Technique Description
Other History:
Arterial hypertension
Parkinson's disease
Atrial fibrillation anticoagulated with acenocoumarol
Benign prostatic hyperplasia
Technique description:
Robotically assisted Ivor-Lewis esophagectomy
Procedure steps:
This is a two-stage procedure: resection of both the distal part of the esophagus and the gastroesophageal junction + creation of a gastric conduit (abdominal part, performed via laparoscopy), ascension of the gastric conduit to the thorax and esophago-gastric hand-sewn anastomosis (thoracic part, robotically assisted).
Abdominal part:
Gastrolysis
Abdominal lymphadenectomy
Creation of the gastric tube/conduit
Ascension of structures to the thorax
Thoracic part:
Robotic docking.
Section of the azygos vein
Distal esophageal dissection + mediastinal lymphadenectomy
Distal esophageal resection
Verification of correct vascularization with ICG green
Totally hand-sewn end-to-end esophago-gastric anastomosis
Training Objectives:
Key-steps of Ivor-Lewis esophagectomy
Robotic surgery, tips and tricks
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