A Novel Intra‐Operative Irrigation‐Drainage System for Robot‐Assisted Thoracoscopic Esophagogastric Layered Anastomosis: Preliminary Practice and Short‐Term Clinical Outcomes

Robot-assisted thoracoscopic surgery facilitates the execution of intrathoracic hand-sewn layered anastomosis during minimally invasive esophagectomy. However, challenges persist due to the complex technical demands inherent in this procedure. Patients who received robot-assisted Ivor-Lewis esophagectomy with intrathoracic hand-sewn layered anastomosis for esophageal cancer were enrolled. A novel irrigation-drainage auxiliary system designed for robot-assisted thoracoscopic esophagectomy was introduced to optimize the execution of intrathoracic hand-sewn layered anastomosis. The anastomosis time, operation time, postoperative complications, and postoperative hospital stay were evaluated. A total of 30 patients were enrolled, and the application of this system resulted in a median anastomosis time of 37 min (range: 28-65). None of the patients experienced postoperative anastomotic leakage or pleural cavity infection, indicating satisfactory short-term safety and efficacy. The device improved operative efficiency by providing better exposure of the anastomotic region, enabling complete abdominal and thoracic drainage and freeing the assistant's hands for other tasks.