A standardized protocol for robot-assisted minimally invasive esophagectomy : improving efficiency and reducing costs

Kitagami, Hidehiko; Poudel, Saseem; Kitayama, Yosuke; Koinuma, Junkichi; Ebihara, Yuma; Hirano, Satoshi

A standardized protocol for robot-assisted minimally invasive esophagectomy : improving efficiency and reducing costs

Kitagami, Hidehiko; Poudel, Saseem; Kitayama, Yosuke et al.

Journal of Robotic Surgery, 2025, 19(1), 107

Permalink : https://hdl.handle.net/2115/97515

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アクセス権	open access
URI	https://hdl.handle.net/2115/97515
タイトル	A standardized protocol for robot-assisted minimally invasive esophagectomy : improving efficiency and reducing costs
著者	Kitagami, Hidehiko ; Poudel, Saseem ; Kitayama, Yosuke ; Koinuma, Junkichi ; Ebihara, Yuma ; Hirano, Satoshi
著者名 Kitagami, Hidehiko
e-Rad_Researcher 80811489 著者名 Poudel, Saseem
著者名 Kitayama, Yosuke
著者名 Koinuma, Junkichi
e-Rad_Researcher 50632981 著者名 Ebihara, Yuma
e-Rad_Researcher 50322813 著者名 Hirano, Satoshi
言語	英語
キーワード	Robot-assisted minimally invasive esophagectomy (RAMIE)
	Esophageal cancer
	Standardization
	Mediastinal dissection
	Cost-effectiveness
	Surgical technique
発行日	2025-03-10
出版者	Springer Nature
収録物名	Journal of Robotic Surgery
巻(号)	19(1)
ページ	107
抄録	Robot-assisted minimally invasive esophagectomy (RAMIE) has shown potential benefits over conventional procedures for esophageal cancer. However, uniform surgical protocols are lacking, leading to variability in outcomes and increased costs. This retrospective study included 180 patients with esophageal cancer who underwent RAMIE between May 2018 and September 2024. A standardized approach, termed counterclockwise partitioned mediastinal dissection (CPMD), was introduced in 114 of these cases. Perioperative parameters including operative time, blood loss, complications, and cost of disposable instruments, were compared between patients treated before and after protocol standardization. Among the 114 patients who received the standardized RAMIE protocol, the median thoracic console time significantly decreased to 148 min, with overall blood loss reduced to 62 ml. No conversions to open surgery were required in either cohort. Compared to the pre-standardization group, postoperative complications-including recurrent laryngeal nerve paralysis-were lower and only one patient needed reoperation. Importantly, reusing robotic instruments from the thoracic phase in the abdominal phase reduced disposable instrument costs, resulting in a savings of approximately 168,000 Japanese Yen (USD 1050) per case. Implementing a standardized RAMIE protocol enhances procedural efficiency, reduces blood loss, and lowers costs without compromising surgical or oncological outcomes. This approach may facilitate broader adoption of RAMIE as a safe and cost-effective strategy for esophageal cancer surgery.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s11701-025-02269-6
PISSN	1863-2483
EISSN	1863-2491
関連情報	PMID 40063141
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s11701-025-02269-6