A safer, more precise procedure

Traditionally, esophagectomies have been high-risk surgeries, requiring large incisions in the chest and abdomen. Recovery could take up to a month in the hospital, followed by months of recovery at home. Robotic-assisted techniques are changing that reality.

Instead of one large incision, surgeons make small incisions in the chest and abdomen. Using the da Vinci 5 robotic surgery system, doctors can operate with more accuracy and control. This allows them to get touch-like (haptic) feedback that helps them feel what’s happening during the surgery.

According to a recent report in the Annals of Thoracic Surgery, robotic esophagectomy “proves to be a safe and effective option for patients with midesophageal to distal esophageal cancers.”

"The advantages of the robotic platform are lesser length of stay in the hospital, earlier return to work or activity because of shortening incisions and better lymph node yield," says Burhan Hassan, MD, staff thoracic surgeon with OSF HealthCare.

Benefits of robotic esophagectomy

Patients undergoing the robotic approach can experience:

• Faster and easier recovery
• Less blood loss
• Reduced pain during recovery
• Minimal scarring
• Lower risk of infection
• Shorter hospital stays
• Greater accuracy in delicate procedures

“Our length of stay since we started performing robotic esophagectomy has come down to seven days on average, which is five days under the national standard,” Dr. Hassan says.

Who is affected by esophageal cancer?

Esophageal cancer generally falls into two types:

• Squamous cell carcinoma – often linked to smoking and alcohol use
• Adenocarcinoma – usually affecting the lower esophagus, with cases on the rise

“While squamous cancer cases have remained steady or even declined, adenocarcinoma cases are increasing, and poor diet is a contributing factor,” Dr. Hassan explains. "Reflux is one of the reasons why a patient would have lower esophagus cancer. Reflux is related to diet. Most gastric cancer is traditionally related to diet, that's why it's mostly seen in the Japanese population, because of the diet there. But in the U.S. subset, the biggest cause is reflux."

More frequent use of scans and EGDs (esophagogastroduodenoscopy) has also led to earlier detection of esophageal cancers, giving patients a better chance of successful treatment.

What patients can expect

A robotic esophagectomy typically lasts five to six hours. Patients usually spend one day in the intensive care unit (ICU) and another five to six days in a general hospital room.

Dr. Hassan and his team aim to completely remove the tumor while preserving surrounding healthy tissue. Recent clinical guidelines also recommend shifting away from radiation as a treatment option, instead favoring chemotherapy followed by surgery for better outcomes.

Transforming cancer care

Once considered one of the most invasive cancer surgeries, esophagectomy is being redefined with robotics. For patients at OSF HealthCare, this means faster recoveries, shorter hospital stays and improved quality of life.

To learn more about robot-assisted surgeries at OSF, visit the OSF HealthCare website.

Video Interview Clips

Da Vinci 5 B-Roll

Artificial intelligence (AI) rapidly expanded in 2023, and it’s here to stay. ChatGPT, Snapchat and altered photos and videos are just some of the AI encounters people have on their devices daily.

AI has many positives. But experts say when it comes to health advice, take it from a trained human being, not a robot. And if you’re scared of “the rise of the robots” – as they say in Hollywood – there are ways to cope.

“You’re absolutely normal to be anxious when there’s the first stirrings of big shifts in technology or other things that might change our life,” says Ari Lakritz, PsyD, a clinical psychologist at OSF HealthCare who says he sees these concerns often.

Coming to grips with technology advances

Common fears include technology making your job obsolete or providing you with misinformation. Dr. Lakritz suggests being proactive to the changes, not reactive. Learn how AI is changing your job or hobbies.

“See if you might be able to be part of that. Start integrating some of that into your day-to-day practice,” Dr. Lakritz says.

AI can be a time-saver, too.

“It has potential to streamline things we don’t like to do, giving us more time and energy to do things we want or things we feel are important,” Dr. Lakritz says.

For example, it may take you an hour to do an online search for sources for your college essay. If ChatGPT can do it in minutes, you might have time to take that afternoon walk or meet a friend for lunch, boosting your mental and physical health and spurring creativity.

It’s also not our first time dealing with digital unknowns. Remember the supposed Y2K bug around the turn of the millennium? Fears of computer clocks malfunctioning and worse didn’t materialize, and experts took away lessons for the next big technology shift, like AI. And a silver lining of the Y2K anxiety, Dr. Lakritz says, is that it got people learning about technology.

Don’t go to a robot for mental health care

Snapchat, the photo messaging application popular with young people, recently rolled out a chatbot called “My AI.” It’s a way for people to connect with someone when they have no one else.

“My AI can answer a burning trivia question, offer advice on the perfect gift for your BFF’s birthday, help plan a hiking trip for a long weekend, or suggest what to make for dinner,” Snapchat’s website says.

But the company concedes: “It’s possible My AI’s responses may include biased, incorrect, harmful, or misleading content. Because My AI is an evolving feature, you should always independently check answers provided by My AI before relying on any advice, and you should not share confidential or sensitive information.”

Some parents and mental health experts have picked up on that concern, too. They worry young people are getting inadequate mental health advice from a robot.

“That’s like Googling your symptoms when you’re sick instead of going to a real doctor,” Dr. Lakritz says with a hint of dismay. “You’ll get a great deal of information, but there will be very little guidance about how to use that information and which information is more applicable to you.”

If talking about your mental health virtually is your preferred way to go, there are more legitimate options than Snapchat, Dr. Lakritz says. First and foremost, your health care provider may offer virtual visits. Otherwise, talk to a provider or trusted adult about online, third-party counseling options.

“These are programs that have been tested and vetted. There’s oversight and accountability. There’s research behind it,” Dr. Lakritz explains. “Whereas with an AI assistant, it’s not clear the source of information. It’s not clear how to use that information best.”

Will AI and chatrooms replace in-person mental health care? Don’t count on it, Dr. Lakritz predicts. The human connection of being in a room with someone can’t be understated, he says.

When in doubt

When the content on your device is just too much to handle, turn it off, set it aside and take a break.

Look for these warning signs:

“Do you feel you’re doing too much of it? Do you find your use of technology is taking over other interests in your life? Have you tried to cut down but have not been able to? Do you find that using so much technology causes you to stress or dysfunction?” Dr. Lakritz asks.

Most devices have settings that can limit screen time. Parents should set boundaries with their children’s device use. Dr. Lakritz says you can even share your browsing or chat history with a trusted adult so they can make sure you’re using technology appropriately.

If your technology use is causing significant mental health problems, talk to your primary care provider or mental health provider. You can also call 9-8-8 to reach the Nation Suicide Prevention Lifeline.

Learn more

Learn more about behavioral and mental health on the OSF HealthCare website.

Interview clips

B-roll

Related stories

Social media and brain changes
Mental health care starts with a first step
Being open and honest about mental health
Tackling pediatric mental health
Is social media impacting your mental health?
TikTok brain
Playing it safe online