Technique and Outcomes of a Reinforced Robotic Ivor-Lewis Esophagectomy Anastomosis

 Camille Yongue MD,, Michael Zervos MD, Costas Bizekis MD

NYU Langone Health, Department of Cardiothoracic Surgery, Division of Thoracic Surgery

Goal: 

To share our technique for a reinforced Ivor Lewis Esophageal robotic anastomosis as well as short term results.

Methods: 

Consecutive series of adult patients from Jan. 2021 to Dec. 2024 who underwent robotic Ivor-Lewis esophagectomy by a two-surgeon thoracic team.

In all cases, the anastomosis was characterized by:

-Securing the gastric conduit to the posterior pleura to reduce tension.

Figure 1: Robotic Port Placement for the Right Chest

Figure 2: Key aspects of robotic Ivor-Lewis anastomotic technique:

 a)Medial pleural tacking suture

c) The proximal esophagus transected with gastrotomy

d) Stapled posterior anastomosis

e) Passing NGT from above

f) 3-0 Barbed sutures run from the posterior wall

g) Tying the anastomosis

h) Wrapping with omental fat

i) Posterior blake