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- •Preface
- •Acknowledgments
- •Contents
- •Contributors
- •1: Robotic Median Arcuate Ligament Release
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •Introduction
- •References
- •3: Robotic Esophagus Leiomyomectomy
- •Introduction
- •Procedure: Illustrated Steps
- •2: Robotic Esophageal Diverticulectomy
- •References
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •5: Robotic Gastric Neurostimulator Placement
- •Introduction
- •References
- •6: Robotic Paraconduit Hernia
- •Introduction
- •Procedures: Illustrated Steps
- •References
- •7: Robotic Partial Fundoplication and Hiatal Hernia Repair
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •8: Robotic Toupet Fundoplication
- •Procedure: Illustrated Steps
- •References
- •9: Robotic Giant Paraesophageal Hernia Repair
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •11: Robotic Pyloroplasty
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •12: Robotic Duodenectomy
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •13: Robotic Esophagectomy: Ivor Lewis
- •Introduction
- •References
- •14: Robotic McKeown Esophagectomy
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •Introduction
- •References
- •Introduction
- •References
- •Introduction
- •Robot-Assisted Total Gastrectomy
- •References
- •18: Robot-Assisted Gastrectomy
- •Introduction
- •Procedure
- •Suggested Reading
- •19: Robot-Assisted Distal Gastrectomy
- •Introduction
- •References
- •Introduction
- •Case Presentation
- •References
- •21: Robotic Vertical Sleeve Gastrectomy
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •22: Robotic Gastric Bypass
- •Introduction
- •Procedure: Illustrated Steps
- •References
- •Suggested Reading
- •24: Robotic Revisional Bariatric Surgery
- •Introduction
- •Patient Education
- •Operating Room Setup
- •Patient Positioning
- •Access/Port Placement
- •Adhesiolysis
- •Hiatal Hernia Repair
- •NAGB
- •LAGB
- •Sleeve Gastrectomy Conversion to Gastric Bypass
- •RYGB
- •Hand-Sewn Gastrojejunostomy Anastomosis
- •Anterior Layer of GJA
- •Leak Test
- •References
- •Index

Omar Yusef Kudsi
Peter P. Grimminger
Editors
Atlas of Robotic Upper
Gastrointestinal Surgery
123

Atlas of Robotic Upper Gastrointestinal Surgery

Omar Yusef Kudsi • Peter P. Grimminger
Editors
Atlas of Robotic Upper
Gastrointestinal Surgery

Editors
Omar Yusef Kudsi
Department of Surgery
Tufts University School of Medicine
Boston, MA, USA
Peter P. Grimminger
Department of General, Visceral and Transplant
Surgery
University Medical Center Mainz
Mainz, Rheinland-Pfalz, Germany
ISBN 978-3-030-86577-1 ISBN 978-3-030-86578-8 (eBook)
https://doi.org/10.1007/978-3-030-86578-8
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or
part of the material is concerned, specically the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microlms or in any other physical way, and transmission or information storage and
retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter
developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a specic statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed
to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty,
expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been
made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

To my family, I share this publishing achievement with you with love and
gratitude. —Omar Yusef Kudsi
This atlas is dedicated to all robotic surgeons in the eld of upper-GI surgery
as well as students and medical staff at the OR. —Peter P. Grimminger

Preface
Advancing from novice to amateur can break the rethinking cycle. As we gain experience, we lose some
of our humility. We take pride in making rapid progress, which promotes a false sense of mastery. That
jump-starts an overcondence cycle, preventing us from doubting what we know and being curious
about what we don’t. We get trapped in a beginner’s bubble of awed assumptions, where we’re ignorant
of our own ignorance.— Excerpt from Adam Grant, “Think Again.”
Over the last decade, there has been an increase in robotic surgery adoption among general
surgeons worldwide. Robotics has become the hot topic of most surgical meetings and social
media surgical platforms such as robotic surgery collaboration with thousands of surgeons
debating the value and discussing the outcomes.
The Atlas of Robotic Upper Gastrointestinal Surgery draws on the expertise of world-class
surgeons to share their pearls of wisdom. The main focus of this atlas is to demonstrate visually
how to perform the most common upper-GI procedures. This is possible via a set of beautiful
high-quality annotated images showing step-by-step guidance on “how to do it.” With a total
of 25 chapters and 50 contributors, this atlas is surely the preeminent source for the newest
techniques by capturing the key points of the procedures, written by experts in the eld actively
involved in robotic upper GI surgery education and hands-on training. Editors Dr. Kudsi (USA)
and Dr. Grimminger (Germany) have hosted and taught hundreds of surgeons and performed
over 3000 robotic surgeries. They have traveled and collaborated with surgeons in the USA,
Europe, South America, and Asia to perform live robotic surgeries.
Boston, MA, USA OmarYusefKudsi
vii

Acknowledgments
I would not have been able to edit this book without the inspiration of my mentors Daniel Jones
at Harvard Medical School; Barry Mann, John Marks, and John Gefen at Lankenau; and
Michael Tarnoff at Tufts. I have had the privilege of working alongside clinical and research
robotic surgery fellows Fahri Gokcal, Naseem Bou-Ayash, Sara Lagrange, Karen Chang, and
Alexandra Chudner. Special thanks to Peter Dion, Susan Michaud, and the staff at Good
Samaritan Medical Center who have helped establish a world-class robotic epicenter and being
a role model for developing one of the most efcient robotic programs in the nation.
Lastly, I would also like to thank my co-editor Dr. Grimminger of Germany, a world-class
surgeon. —Omar Yusef Kudsi
Many thanks to Lee Klein from Springer for the great support and communications.
Special thanks to UGIRA (UGIRA.org) for all the support, especially the UGIRA President:
Richard van Hillegersberg. Thank you. —Peter P. Grimminger
ix

Contents
1 Robotic Median Arcuate Ligament Release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Kevin El-Hayek
2 Robotic Esophageal Diverticulectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
William C. Sherrill III and Michael M. Awad
3 Robotic Esophagus Leiomyomectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Benedikt Reichert and Jan-Hendrik Egberts
4 Robotic Heller Myotomy with Dor Fundoplication . . . . . . . . . . . . . . . . . . . . . . . . . 27
Laura Lorenzon, Alberto Biondi, Pietro Santocchi, and Domenico D’Ugo
5 Robotic Gastric Neurostimulator Placement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
William C. Sherrill III and Michael M. Awad
6 Robotic Paraconduit Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55
Ashwini S. Poola, Torjborg Holtestaul, Laila Rashidi, and Prakash Gatta
7 Robotic Partial Fundoplication and Hiatal Hernia Repair . . . . . . . . . . . . . . . . . . . 61
Frank J. Voskens, Jelle P. Ruurda, and Ivo A. M. J. Broeders
8 Robotic Toupet Fundoplication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Mickael Chevallay, Marco Augusto Bonino, Minoa Karin Jung,
and Stefan Paul Mönig
9 Robotic Giant Paraesophageal Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Caitlin Houghton
10 Robotic Truncal Vagotomy and Antrectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Fazaldin Moghul and Abubaker A. Ali
11 Robotic Pyloroplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Katherine Fay and Ankit D. Patel
12 Robotic Duodenectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
Torben Glatz and Dirk Bausch
13 Robotic Esophagectomy: Ivor Lewis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Peter P. Grimminger, Giovanni Capovilla, and Evangelos Tagkalos
14 Robotic McKeown Esophagectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Richard van Hillegersberg, Eline de Groot, and Jelle P. Ruurda
15 Robotic Transcervical and Transhiatal Esophagectomy (RACE Procedure) . . . . 157
Peter P. Grimminger, Giovanni Capovilla, Carolina Froiio, and Hubert Stein
16 Robotic-Assisted Proximal Gastrectomy with Double Tract Reconstruction . . . .171
Peter P. Grimminger, Giovanni Capovilla, and Felix Berlth
xi

xii
17 Robot-Assisted Total Gastrectomy and Roux-en-Y Reconstruction . . . . . . . . . . . 185
Han-Kwang Yang and Felix Berlth
18 Robot-Assisted Gastrectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Adrian Billeter, Martin Wagner, Manuela Capek, and Beat Peter Müller-Stich
19 Robot-Assisted Distal Gastrectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 213
Han-Kwang Yang and Felix Berlth
20 Robotic Partial Gastrectomy for GIST Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Matthias Biebl, Christian Denecke, Tomasz Dziodzio, Robert Öllinger, and
Johann Pratschke
21 Robotic Vertical Sleeve Gastrectomy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
Hany Takla and Augustus Gleason
22 Robotic Gastric Bypass . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Jan-Niclas Kersebaum and Jan Henrik Beckmann
23 Robotic Duodenal Switch (rDS) and Robotic Single Anastomosis
Duodenal-Ileal Bypass with Sleeve Gastrectomy (rSADI-S) . . . . . . . . . . . . . . . . . . 257
Curtis Peery
24 Robotic Revisional Bariatric Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273
Danuel Laan and Carlos A. Galvani
Contents
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285

Contributors
AbubakerA.Ali, MD Department of General Surgery, Wayne State University, Detroit, MI,
USA
MichaelM. Awad, MD, PhD, FACS Section of Minimally Invasive Surgery, Washington
University School of Medicine, St Louis, MO, USA
DirkBausch, MD Department of Surgery, Marien Hospital Herne, Universitätsklinikum der
Ruhr-Universität Bochum, Herne, Germany
Jan Henrik Beckmann, MD UKSH Department of General, Visceral-, Thoracic-,
Transplantation-, and Pediatric Surgery, University Medical Center Schleswig-Holstein, Kiel,
Germany
Felix Berlth, MD Department of General, Visceral and Transplant Surgery, University
Medical Center of the Johannes Gutenberg University, Mainz, Germany
MatthiasBiebl Department of Surgery, Campus Charité Mitte|Campus Virchow Klinikum,
Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin,
Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
AdrianBilleter, MD, PhD Department for General, Visceral and Transplantation Surgery,
Division for Minimally Invasive and Robot-Assisted Surgery, Division for Upper
Gastrointestinal Surgery, Heidelberg University Hospital, Heidelberg, Germany
Alberto Biondi, MD Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic
University of the Sacred Heart, Rome, Italy
MarcoAugustoBonino, MD Division of Digestive Surgery, Department of Surgery, Geneva
University Hospital and Faculty of Medicine, Geneva, Switzerland
Ivo A. M. J. Broeders, MD, PhD Department of Surgery, Meander Medical Center,
Amersfoort, The Netherlands
University of Twente, Robotics and Mechatronics, Enschede, The Netherlands
Manuela Capek, MD Department for General, Visceral and Transplantation Surgery,
Division for Minimally Invasive and Robot-Assisted Surgery, Division for Upper
Gastrointestinal Surgery, Heidelberg University Hospital, Heidelberg, Germany
Giovanni Capovilla, MD Department of General-, Visceral- and Transplant Surgery,
University Medical Center Mainz, Mainz, Germany
Mickael Chevallay, MD Division of Digestive Surgery, Department of Surgery, Geneva
University Hospital and Faculty of Medicine, Geneva, Switzerland
Christian Denecke, MD Department of Surgery, Campus Charité Mitte|Campus Virchow
Klinikum, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität
Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
xiii
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