Robot-assisted surgery for esophageal cancer

ESOPHAGEAL SURGERY is one of the most difficult, time-consuming and dangerous areas. In cancer and some benign diseases, patients may be shown complete (esophagectomy) or partial removal of it. As a rule, the stomach is used to replace the diseased organ, and in some cases, a section of the small or large intestine. Traditionally, operations for esophageal diseases, most often malignant, were performed from three incisions (on the right half of the chest, on the abdomen and on the neck). At the same time, the presence of a large incision did not guarantee a good view and access to the operating field. 
When using robotic technology, small punctures are performed instead of incisions, and the advantages listed above give the surgeon the opportunity to clearly visualize the operating field and perform all the necessary manipulations of any complexity.
To date, such operations in our center are performed completely minimally invasive (thoracolaparoscopically), when instead of traumatic extended incisions on the chest and abdominal wall, small punctures are performed. 


Since 2015, such operations by employees of the Department of Innovative Surgery have been performed using a ROBOT! 
Robot-assisted surgery is one of the most innovative areas in modern medicine.
The use of the Da Vinci robotic complex in performing high-tech surgical operations has allowed us to take surgical treatment to a new level by overcoming many of the limitations inherent in thoracolaparoscopic and open surgery.

During such interventions, the surgeon sits at a special console installed a few meters from the operating table, from where the robot's "hands" are controlled, in which special tools are fixed. The robotic" hand", controlled by the surgeon, produces much more precise and small movements, which eliminates the inherent tremor factor of the human hand. In addition, the "hand" of the robot can freely rotate in different planes, without having angles restrictions, unlike the human hand.
The image from the abdominal or thoracic cavities is transmitted through the camera inserted inside to a special screen located on the front surface of the console. Multiple magnification, adjustable viewing angle and the ability to use a 3D image allow you to perform actions (cutting, stitching, tissue coagulation) at a high-precision level. As a result, the probability of accidental damage to important structures, blood vessels and nerves is reduced, and, accordingly, the risk of complications is reduced. 
It should be noted that the incisions in robot-assisted operations do not exceed 10-12 mm!, which is much less than in the traditional approach. This circumstance practically eliminates the development of infectious complications from wounds, improves their healing and minimizes the likelihood of hernia defects in the long-term postoperative period.
Due to the minimal trauma of the intervention, the best functional and cosmetic effect is achieved. Patients can be discharged from the hospital faster, due to an easier recovery period. 
At the same time, robot-assisted operations have advantages not only for the patient, but also for the operating surgeon, ensuring the comfort of his work.

Today, the staff of the Innovative surgery department of the MCSC DZM, in addition to operations on the esophagus, use the Da Vinci robotic complex (Da Vinci) when performing surgical interventions on the stomach and pancreas.

GBUZ Moscow Clinical Scientific Center named after Loginov MHD