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The first series of completely robotic esophagectomies with three-field lymphadenectomy: initial experience

机译：第一批完全机械化食管切开术联合三视野淋巴结清扫术：初步经验

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We appreciate the comments by Drs. Boone, Rinkes, and. Hillegersberg from the University Medical Center in Ut-rect. It is encouraging to see other groups investigating robotic technology for the treatment of esophageal cancer. We appear to have had learning experience.We are aware of the dorsocranial robotic chassis 'positioning used by their group and others. Our chassis position, directly dorsal, seems te be especially helpful for patients who have lower esophageal cancers. For these cancers, we not only to reach the esophageal hiatus, but also to continue our., dissection into the thoraeic inlet. At those two extremes (the hiatus and the thoracic inlet), robotic arm reach and mobility can be limited without our direct dorsal robots chassis position. With the more dorsocranial position, as recommended by Boone et al. we have found significant limitations to perform a wide resection at the esophageal hiatus.In many of our recent cases and not included in the first. series-article, we have.found it necessary to remove por-. tions of the diaphragm; the pericardium, and the left lower lobe from the right chest approach which the more dorsocranial chassis positioning would likely make it difficult for us to perform. Perhaps with more centrally located tumors seen at the other institutions, the necessity o％swide resection at the hiatus may be less important and thus, the dorsocranial position may suffice.
机译：我们感谢Drs的评论。布恩，林克斯和。乌勒格大学医学中心的Hillegersberg。令人鼓舞的是，其他团体正在研究用于治疗食道癌的机器人技术。我们似乎有学习经验。我们知道他们的小组和其他人使用的背颅机器人底盘定位。我们的直接位于背部的底盘位置对于食管癌较低的患者特别有用。对于这些癌症，我们不仅要达到食管裂孔，还要继续将我们的解剖切入胸腔入口。在这两种极端情况下（裂孔和胸腔入口），如果没有我们的直接背侧机器人底盘位置，则可以限制机械臂的伸展范围和移动性。根据Boone等人的建议，具有较高的背颅位。我们发现食管裂孔广泛切除的局限性很大。在我们最近的许多病例中，并没有包括在第一例中。系列文章，我们发现有必要删除por-。隔膜的位置;心包，以及右胸入路的左下叶，这可能会增加我们背颅底盘的位置。也许在其他机构发现的肿瘤位于更中心的位置时，在裂孔处进行大范围切除的必要性可能不那么重要，因此，背颅位置就足够了。

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