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Robotic-assisted Ivor Lewis esophagectomy with combined stapled/sewn anastomosis

The esophagectomy remains the primary modality of treatment for localized esophageal cancer. A formidable operation for surgeons given its technical complexity and associated morbidity and mortality. Accordingly, a minimally invasive approach has become increasingly utilized given the reduced perioperative morbidity, shortened hospital stay, and improved patient satisfaction when compared to the traditional open esophagectomy. A variety of surgical techniques exist for the construction of the esophagogastric anastomosis, including a hand-sewn, circular stapled, linear stapled, or a combined stapled/sewn (modified Collard) approach. In this article, we detail our two staged approach to the robotic-assisted Ivor Lewis esophagectomy with combined stapled/sewn anastomosis.