Robot-assisted minimally invasive esophagectomy (RAMIE) shows lower nerve injury rates compared to conventional minimally invasive esophagectomy (MIE) for esophageal cancer.

• RAMIE had an operative time of 629 minutes vs. 574 minutes for MIE (p < 0.01).
• Incidence of recurrent laryngeal nerve (RLN) palsy was 22% with RAMIE vs. 34% with MIE (p = 0.02).

Both techniques yielded similar long-term survival rates (3-year: RAMIE 77% vs. MIE 74%; 5-year: both 66%).

• Morbidity was slightly lower with RAMIE (18% grade ≥ III vs. 23%) without significant differences in blood loss or in-hospital mortality.