Minimally invasive techniques reduce complications in esophagectomy without affecting survival.

• Pulmonary complications are 53% lower with minimally invasive esophagectomy (MIE) and 61% lower with robot-assisted MIE compared to open esophagectomy.
• Robot-assisted MIE shows higher lymph node yield and lower reoperation rates than open approaches.

Surgeons should consider MIE and robot-assisted techniques to enhance patient outcomes while minimizing risks.

• Hybrid approaches may increase anastomotic leakage compared to open surgery.