Robotic Enucleation of an Esophageal Submucosal Tumor in the Prone Position

Background: Esophageal submucosal gastrointestinal stromal tumors (GISTs) are rare. Resection is indicated due to their malignant potential. Case Description: A 76-year-old woman complained of mild dysphagia. A submucosal tumor of the lower thoracic esophagus was found endoscopically. Computed tomography (CT) scan revealed a 40-mm anterolateral submucosal tumor. Endoscopic ultrasound revealed a hypoechoic and inhomogeneous lesion, developed from the fourth layer of the lower esophagus. In the prone position, the patient underwent robot-assisted right thoracoscopic enucleation of the esophageal submucosal tumor. The procedure was successfully completed with three trocars. No surgical complications occurred during the intervention or the postoperative stay. The patient was discharged on postoperative. Pathologic examination of the specimen revealed a GIST. Conclusion: To the best of our knowledge, this is the first report of esophageal submucosal GIST enucleation with a patient in the prone position using robotic surgery platform. This approach, which complements the prone position by allowing a more precise dissection, is particularly appropriate for submucosal tumor enucleation and needs to be further evaluated.