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Minimally invasive esophagectomy in a patient in a prone position

Epublication WebSurg.com, Jul 2006;06(07). URL: http://websurg.com/doi/vd01en1982

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  • 2006-07-03
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This video demonstrates a total esophagectomy for a cancer of distal esophagus. The surgeon starts with right thoracoscopy with the patient in a prone position. The esophagus and adjoining lymphatics are mobilized and separated from the adjoining structures. The azygos vein is divided. Once full mobilization of the thoracic esophagus is achieved, a chest tube is inserted and the trocars are removed and the patient is put in a supine position. The surgeon now performs laparoscopic dissection of the left gastric vessels and lymphatics. A gastric tube is created and duodenum is kocherized. After full mobilization of the gastroesophageal junction and the tumor at the hiatus, a cervicotomy is carried out and the esophagus is pulled out through the cervical incision. The esophagus is resected and a side-to-side stapled anastomosis is made between the cervical esophagus and the gastric tube.