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

“That’s going to change the way we do a lot of major urologic procedures. Instead of using multiple incisions, we use one or two incisions and get the job done that way,” says James Sylora, MD, urologist at OSF Little Company of Mary. “That should increase patient comfort and get them home earlier and back to work sooner.”

According to Dr. Sylora, the single-port robot will now be used for 90% of urologic procedures, such as surgeries to remove all (nephrectomy) or part of a kidney (partial nephrectomy). This is done primarily to treat kidney cancer. This can also be used for benign and reconstructive procedures.

The SP Robot allows the surgical team to access target organs in patients who have previously undergone surgery. Beforehand, scar tissue would have made it more difficult, Dr. Sylora says.

Most patients being treated with this technology have localized prostate cancer or small renal masses. In cases of renal cancer, the single-port robot helps preserve kidney function.

Thanks to this new approach, most patients can return home the same day as their procedure - a major improvement from previous procedures that required multiple days of hospital recovery. The need for pain medication has also dropped significantly.

“Several of the patients take a few Tylenol #3 or extra strength Tylenol as their post-operation pain medication. It’s quite remarkable,” Dr. Sylora says. “I wouldn’t have believed it until I started doing it. And sure enough, it’s true.”

The OSF Little Company of Mary team began using the single-port robot earlier this year and has already treated roughly a dozen patients with promising results.

“OSF has invested in having this new technology. They’re one of the only private hospitals across the country to have invested in this type of technology,” Dr. Sylora says. “They’re staying at the cutting-edge and we’re happy to provide this service.”

The Da Vinci SP system enables robotic-assisted surgery through a single incision, offering a streamlined and less invasive alternative for patients. Its specialized design, flexible instruments and enhanced vision support a new generation of surgical precision and recovery.