Innovations in Minimally Invasive Management of Esophageal Atresia and Tracheoesophageal Fistula
Abstract
:1. Introduction
1.1. Definition and Classification of Esophageal Atresia and Tracheoesophageal Fistula
1.2. Advances in the Surgical Treatment of Esophageal Atresia
1.2.1. Thoracoscopic Repair
1.2.2. Robotic-Assisted Surgery
1.2.3. Tissue Engineering
1.3. Comparative Advantages of MIS Compared to Open Surgery
2. Preoperative Considerations and Preparation
2.1. Prenatal Diagnosis and Counseling
2.2. Patient Selection and Criteria for MIS
2.3. Preoperative Paraclinical Evaluation
2.4. Anesthetic Considerations and Intraoperative Management
3. Thoracoscopic Repair of Esophageal Atresia
3.1. Surgical Technique and Instrumentation
3.2. Primary Anastomosis via Thoracoscopy
3.3. Challenges and Technical Pitfalls
4. Minimally Invasive Techniques in Long-Gap Esophageal Atresia
4.1. Definition and Challenges of Long-Gap EA
4.2. Minimally Invasive Foker Technique (Internal Traction Approach)
4.3. Delayed Primary Anastomosis and the Role of Gastrostomy
4.4. Alternative Minimally Invasive Approaches
4.4.1. Thoracoscopic Esophageal Elongation
4.4.2. Endoscopic and Combined Thoracoscopic–Endoscopic Techniques
4.4.3. Magnetic Compression Anastomosis (Magnamosis)
5. Robotic-Assisted Surgery in EA and TEF
6. Postoperative Management and Complications After Minimally Invasive Surgery
7. Long-Term Outcomes After Minimally Invasive Repair
8. Emerging Techniques and Innovations in Minimally Invasive EA/TEF Surgery
9. Challenges, Limitations, and Future Directions
10. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Gross Type | Vogt/Ladd Type | Esophageal Anatomy | Tracheoesophageal Fistula (TEF) | Approximate Incidence (%) |
---|---|---|---|---|
- | Type 1/- | Esophageal agenesia | - | - |
Type A | Type 2/I | Upper and lower esophagus are blind-ended pouches | Absent | 5–10 |
Type B | Type 3A/II | Upper pouch with blind lower esophagus | Proximal (to trachea) | 1–2 |
Type C | Type 3B/III, IV | Upper pouch with lower esophagus connected to the trachea | Distal (to trachea) | 80–90 |
Type D | Type 3C/V | Upper and lower pouches with separate connections to trachea | Proximal and distal | <1 |
Type E | Type 4 or H-type/- | Esophagus is continuous | Present (between trachea and esophagus) | 4–8 |
Criterion | Threshold |
---|---|
Birth Weight | >2.500 g |
Gestational Age | >34–36 weeks |
Cardiac Status | Absence of severe congenital heart anomalies |
Respiratory Stability | Stable; no need for high-frequency ventilation or significant oxygen support |
Gap Length | Short to moderate; primary anastomosis possible without significant tension |
Associated Anomalies | No major anomalies requiring immediate surgery (e.g., abdominal wall defects) |
Surgical and Institutional Factors | Availability of an experienced MIS team and neonatal intensive care resources |
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Surd, A.; Muresan, R.; Ciongradi, C.I.; Sur, L.M.; Usatiuc, L.O.; Snakovszki, K.; Munteanu, C.; Sârbu, I. Innovations in Minimally Invasive Management of Esophageal Atresia and Tracheoesophageal Fistula. Gastrointest. Disord. 2025, 7, 39. https://doi.org/10.3390/gidisord7020039
Surd A, Muresan R, Ciongradi CI, Sur LM, Usatiuc LO, Snakovszki K, Munteanu C, Sârbu I. Innovations in Minimally Invasive Management of Esophageal Atresia and Tracheoesophageal Fistula. Gastrointestinal Disorders. 2025; 7(2):39. https://doi.org/10.3390/gidisord7020039
Chicago/Turabian StyleSurd, Adrian, Rodica Muresan, Carmen Iulia Ciongradi, Lucia Maria Sur, Lia Oxana Usatiuc, Kriszta Snakovszki, Camelia Munteanu, and Ioan Sârbu. 2025. "Innovations in Minimally Invasive Management of Esophageal Atresia and Tracheoesophageal Fistula" Gastrointestinal Disorders 7, no. 2: 39. https://doi.org/10.3390/gidisord7020039
APA StyleSurd, A., Muresan, R., Ciongradi, C. I., Sur, L. M., Usatiuc, L. O., Snakovszki, K., Munteanu, C., & Sârbu, I. (2025). Innovations in Minimally Invasive Management of Esophageal Atresia and Tracheoesophageal Fistula. Gastrointestinal Disorders, 7(2), 39. https://doi.org/10.3390/gidisord7020039