OA06-LBA01.2. Repurposing Monopolar Curved Scissors (MCS) as a Functional Intra Operative Nerve Monitor (IONM) Probe in Robotic Esophagectomy: Early Clinical Experience

Clicks: 19
ID: 326092
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Steady

Ranked #250 of 453 articles by views in diseases of the esophagus : official journal of the international society for diseases of the esophagus

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 453 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Topic Esophageal Cancer: Surgical Treatment of Esophageal Cancer – technique Background Recurrent laryngeal nerve (RLN) injury remains a significant concern during esophagectomy, particularly during extensive mediastinal lymphadenectomy, where the risk of nerve damage is high. Intraoperative nerve monitoring (IONM) has been increasingly adopted to help identify and preserve the RLN, potentially reducing postoperative vocal cord palsy. However, the use of dedicated IONM probes may increase procedural cost and disrupt the efficiency of the robotic surgical workflow. Integrating nerve monitoring into existing robotic instruments could simplify the process. This study evaluates the feasibility, safety, and early clinical outcomes of using monopolar curved scissors as a functional IONM probe. Methods A prospective observational study of 22 consecutive patients undergoing robotic-assisted esophagectomy with intraoperative nerve monitoring (IONM) using monopolar curved scissors was conducted. All procedures were performed in the semiprone position using the da Vinci Xi Surgical System. A Medtronic nerve monitoring system was used in all cases. Data collected included patient demographics, tumor histology, neoadjuvant treatment, surgical approach, extent of lymphadenectomy, and recurrent laryngeal nerve (RLN) outcomes. Both extended two-field and total mediastinal (three-field) lymph node dissections were performed using McKeown and Ivor Lewis approaches. Monopolar curved scissors were utilized as the stimulation probe for IONM in all cases without the need for additional instruments. Pathological stage and nodal involvement were also evaluated to assess oncological adequacy. Standard perioperative protocols were followed consistently across all patients. Results A total of 22 patients were included (15 males, 7 females). Surgical details: IONM using MCS was successfully performed in all cases without technical difficulty. Recurrent laryngeal nerve outcomes: All cases of temporary RLN paresis are resolved within an 8-week follow-up period. No complications related to the use of MCS for IONM were observed. Pathological stage and nodal involvement were also evaluated. Conclusion Monopolar curved scissors (MCS) can be effectively repurposed as a functional intraoperative nerve monitoring (IONM) probe during robotic-assisted esophagectomy. This approach is feasible, safe, and cost-effective. The dual use of MCS as both a dissector and nerve monitoring probe integrates seamlessly into the robotic workflow, achieved simply by switching the energy connection at the instrument interface, without requiring additional instruments. Early results demonstrate acceptable recurrent laryngeal nerve (RLN) palsy rates with no permanent nerve injury. This technique may promote wider adoption of IONM in minimally invasive esophageal surgery. Further studies with larger cohorts are required to validate these findings. Video Description This video demonstrates a simple and innovative technique of using monopolar curved scissors (MCS) as a functional intraoperative nerve monitoring (IONM) probe during robotic-assisted esophagectomy. In the initial segment, we illustrate the setup. The standard MCS energy cord is disconnected from the electrosurgical unit and connected directly to the nerve monitoring system. This straightforward modification enables the same instrument to function as a nerve stimulation probe without requiring any additional IONM probes, thereby maintaining cost-effectiveness and procedural efficiency. In the second part of the video, we demonstrate the practical application of this technique during mediastinal dissection. The MCS is used to stimulate and identify the right recurrent laryngeal nerve, followed by similar mapping of the left recurrent laryngeal nerve. Clear and reproducible nerve signals are obtained, facilitating precise identification and preservation of both nerves during lymphadenectomy. Importantly, the instrument seamlessly transitions between dissection and nerve monitoring functions by simply switching the energy connection, without interrupting the robotic workflow. This eliminates the need for instrument exchange and enhances surgical ergonomics. Our early clinical experience suggests that this technique is feasible, safe, and easily adaptable. It offers a practical solution for integrating IONM into robotic esophagectomy while minimizing additional costs and maintaining operative efficiency. This approach may support wider adoption of nerve monitoring and contribute to improved functional outcomes in esophageal cancer surgery.
Reference Key
openalex_W7204000997 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Devendra Parikh, Jagdish Kothari, Bharat Prajapati
Are you one of these authors? Claim your profile
Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.043
URL
https://doi.org/10.1093/dote/doag077.043
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.