VA02.4. Robotic Oesophagectomy With Colon Interposition Using Right Colon and Oesophago - Ileal Neck Anastomosis

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ID: 326010
2026
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Ranked #147 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

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Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – technique Background The ever increasing number of patients undergoing metabolic/bariatric surgery poses challenges in oesophageal reconstruction in those who subsequently develop oesophageal cancer. Robotic assisted surgery may play a role achieving an optimal outcome in these difficult cases. Methods We present the case of a 56 year old woman who underwent neoadjuvant treatment of an oesophageal squamous cell carcinoma. Restaging showed a favorable response and the regional multidisciplinary team meeting recommended oesophagectomy. Reconstructive options were limited as this patient previously underwent a sleeve gastrectomy followed by a conversion to roux - en - y bypass for reflux and suboptimal weight gain. We display our technique for a robotic three stage oesophagectomy, with a right colon interposition graft used to restore gastrointestinal continuity. Results A four port technique was used to perform the thoracic phase of of the oesophagectomy, with mobilization of the oesophagus carried on high up into the neck. A completely robotic mobilization of the right colon was performed with clamping of the ileocolic vessels and a perfusion assessment, to simulate ileocolic vessel ligation. The gastric pouch and distal oesophagus were mobilized and the alimentary limb of the bypass was divided. Distal aspect of the colon graft was anastomosed to the alimentary limb. A neck dissection was performed and specimen removed via upper midline mini-laparotomy. The colon graft was exteriorised and prepared for anastomosis. An anastomosis was performed in the neck between the ileum of the right colon graft and the cervical oesophagus. The patient was discharged on post-operative day nine with no major complications. Conclusion The use of a colon interposition graft is a safe and feasible option for reconstructing complex anatomy after oesophagectomy. Robotic technology can greatly assist in this technically complex operation. Video Description This video presents the case of a woman who underwent neoadjuvant treatment of an oesophageal SCC. Restaging showed a good response and regional MDT recommended to proceed with oesophagectomy. Her reconstruction options were limited as she previously had a sleeve gastrectomy which was later converted to a Roux - en - Y bypass, thus a precluding gastric conduit. This was a challenging reconstructive situation and our video displays our technique of robotic assisted three stage oesophagectomy. This video includes a completely robotic mobilization of the right colon which is used to restore continuity with an ileo-oesophageal anastomosis in the neck, and a colon to alimentary limb of the bypass anastomosis in the abdomen. To our knowledge, such a complex operation and reconstruction has never been described before. Given the increasing number of patients undergoing metabolic/bariatric surgery, such a video will be of great educational value to Congress members who may be faced with a similar situation.
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Authors Colm Neary, Laura McAteer, William Robb
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.439
URL
https://doi.org/10.1093/dote/doag077.439
Keywords Keywords not found

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