{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T04:55:07Z","timestamp":1790139307255,"version":"4.0.1"},"reference-count":34,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T00:00:00Z","timestamp":1695081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Postesophagectomy diaphragmatic prolapse (PDP) is a major complication after esophagectomy with significant mortality and morbidity. However, in the current literature, treatment and outcomes are not evaluated for patients undergoing an Ivor Lewis Robot-assisted minimally invasive esophagectomy (IL-RAMIE). The aim of this study is to evaluate the incidence of PDP after IL-RAMIE. Moreover, the study aims to determine whether using a minimally invasive approach in the management of PDP after an IL-RAMIE procedure is safe and feasible. Materials and Methods: This study includes all patients who received an IL-RAMIE at our high-volume center (&gt;200 esophagectomies\/year) between April 2017 and December 2022 and developed PDP. The analysis focuses on time to prolapse, symptoms, treatment, surgical method, and recurrence rates of these patients. Results: A total of 185 patients underwent an IL-RAMIE at our hospital. Eleven patients (5.9%) developed PDP. Patients presented with PDP after a medium time of 241 days with symptoms like reflux, nausea, vomiting, and pain. One-third of these patients did not suffer from any symptoms. In all cases, a CT scan was performed in which the colon transversum always presented as the herniated organ. In one patient, prolapse of the small intestine, pancreas, and greater omentum also occurred. A total of 91% of these patients received a revisional surgery in a minimally invasive manner with a mean hospital stay of 12 days. In four patients, PDP recurred (36%) after 13, 114, 119 and 237 days, respectively. Conclusion: This study shows that a minimally invasive approach in repositioning PDP is a safe and effective option after IL-RAMIE.<\/jats:p>","DOI":"10.3390\/jcm12186046","type":"journal-article","created":{"date-parts":[[2023,9,19]],"date-time":"2023-09-19T23:17:20Z","timestamp":1695165440000},"page":"6046","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Postesophagectomy Diaphragmatic Prolapse after Robot-Assisted Minimally Invasive Esophagectomy (RAMIE)"],"prefix":"10.3390","volume":"12","author":[{"given":"Stefanie","family":"Brunner","sequence":"first","affiliation":[{"name":"Department of General, Visceral, Cancer and Transplantat Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1833-5664","authenticated-orcid":false,"given":"Dolores T.","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Cancer and Transplantat Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A.","family":"Eckhoff","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Cancer and Transplantat Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentin","family":"Lange","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Cologne, 50923 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8923-6428","authenticated-orcid":false,"given":"Seung-Hun","family":"Chon","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Cancer and Transplantat Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Cancer and Transplantat Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8700-069X","authenticated-orcid":false,"given":"Wolfgang","family":"Schr\u00f6der","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Cancer and Transplantat Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane J.","family":"Bruns","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Cancer and Transplantat Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4764-8050","authenticated-orcid":false,"given":"Hans F.","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of General, Visceral, Cancer and Transplantat Surgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. 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