Evidence map›Paper›PMID 41263984›Full record

ArticleSurgery today2026

Standardization using soft coagulation scissors and Maryland bipolar forceps techniques reduces the operative time and incidence of recurrent laryngeal nerve palsy in robot-assisted minimally invasive esophagectomy.

Hironobu Goto, Yasufumi Koterazawa, Tomoaki Aoki, Yutaka Sugita, Taro Ikeda, Hitoshi Harada, Yasunori Otowa, Naoki Urakawa, Hiroshi Hasegawa, Shingo Kanaji and 3 more

Abstract read
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In one paragraph

Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Hironobu GotoDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan. hirogoto@med.kobe-u.ac.jp.ORCID http://orcid.org/0000-0002-4337-5529
Yasufumi KoterazawaDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Tomoaki AokiDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Yutaka SugitaDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Taro IkedaDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Hitoshi HaradaDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Yasunori OtowaDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Naoki UrakawaDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Hiroshi HasegawaDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Shingo KanajiDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Takeru MatsudaDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.
Taro OshikiriDivision of Gastrointestinal Surgery and Surgical Oncology, Graduate School of Medicine, Ehime University, Shitsukawa 454, Toon, Ehime, 791- 0295, Japan.
Yoshihiro KakejiDivision of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Hyogo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMinimally invasive esophagectomy (MIE) is the standard surgical procedure. Robot-assisted MIE (RAMIE) was developed to overcome the problems associated with conventional MIE. This study investigated whether or not standardizing surgical procedures for RAMIE using soft coagulation scissors and Maryland bipolar forceps could improve short-term outcomes.

methodsThis study included 130 patients who underwent RAMIE. Clinicopathological characteristics and surgical outcomes were compared before and after standardization by two expert surgeons as well as between the standardized and trainee groups. A cumulative sum control chart (CUSUM) was used to evaluate changes in operative time.

resultsThe console time during the thoracic procedure was shorter in the standardized group than in the pre-standardized group (P < 0.001). The rate of recurrent laryngeal nerve palsy was lower in the standardized group than in the pre-standardized group (P = 0.039). No significant differences were observed between the standardized and trainee groups. In the standardized and trainee groups, CUSUM clearly indicated that the console time peak occurred in the 12th and 16th cases.

conclusionsStandardization of surgical procedures using an appropriate device for each surgical step could improve surgical outcomes in RAMIE. Furthermore, it may facilitate safer and more efficient surgical training.

Indexed as

EsophagectomyMinimally Invasive Surgical ProceduresOperative TimePostoperative ComplicationsRecurrent Laryngeal Nerve InjuriesRobotic Surgical ProceduresSurgical InstrumentsVocal Cord ParalysisAgedFemaleHumansIncidenceMaleMiddle AgedTreatment OutcomeEsophageal cancerLearning curveRobot-assisted minimally invasive esophagectomyStandardization of surgical techniques

Identifiers

PMID41263984

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.