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This article is the author's final published version in Video-Assisted Thoracic Surgery, Volume 6, March issue, March 2021, Pages 1-6.

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Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See:


While traditionally performed through an open approach, the role of minimally invasive technologies has evolved in its application to esophageal resection. Esophagectomy is associated with significant morbidity, which has led to interest in developing minimally invasive esophagectomy (e.g., laparoscopic/thoracoscopic approaches) to address this issue. As a result, the role of minimally invasive approaches for esophageal resection has evolved, with a growing body of literature describing these techniques. Minimally invasive approaches have been applied to transhiatal esophagectomy, with application of both laparoscopic and robotic-assisted techniques. Although minimally invasive esophagectomy approaches are well-described in the literature for esophageal malignancies, the efficacy of robotic-assisted esophagectomy is not as well established. Since the initial reports of this application, the adoption of this technology for esophagectomy has continued to expand. As the role for robotic techniques has expanded across esophageal resection approaches, a more defined application to minimally invasive transhiatal esophagectomy (MI-THE) has developed. Our group has sought to adapt laparoscopic and robotic techniques to the transhiatal approach for both malignant and end-stage benign esophageal disease. With growing MI-THE experience, operative technique has been further refined. This report describes the operative technique and best practices for robotic-assisted transhiatal esophagectomy with cervical esophagogastric anastomosis, including preoperative preparation, operative technique, postoperative care, and perioperative outcomes.

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