Surgical Endoscopy

, Volume 3, Issue 2, pp 63–69 | Cite as

Endoscopic microsurgical dissection of the esophagus

Results in an animal model
  • K. Kipfmüller
  • M. Naruhn
  • A. Melzer
  • S. Kessler
  • G. Bueß
Original Articles


Blunt dissection of the esophagus is considered the least invasive technique in the treatment of either benign or malignant diseases of the esophagus. Its disadvantage is that it has to be carried out blindly. The results may be uncontrollable hemorrhage, unrecognized injuries to the trachea, and damage to the recurrent laryngeal nerve. In order to reduce the degree of invasivness a new endoscopic microsurgical technique for the dissection of the esophagus has been developed and tried out in animals. This paper presents the operative technique. Our new endoscopic microsurgical technique obviates a thoracotomy, while direct endoscopic vision results in improved dissection. The magnified endoscopic view permits selective exposure of blood vessels and prevents injury to the adjacent organs.

Key words

Esophagus Esophagectomy Transhiatal esophagectomy Endoscopic microsurgical dissection Minimal invasive surgery 


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  1. 1.
    Barbier PA, Becker CD, Wagner HE (1988) Esophageal carcinoma: patient selection for transhiatal esophagectomy. A prospective analysis of 50 consecutive cases. World J Surg 12: 263–269Google Scholar
  2. 2.
    Finley RJ, Grace M, Duff JH (1985) Esophagogastrectomy without thoracotomy for carcinoma of the cardia and lower part of the esophagus. Surg Gynecol Obstet 160: 49–56Google Scholar
  3. 3.
    Junginger T, Bueß G, Jugenheimer M (1988) Das Ösophaguskarzinom. Ärztebl Rheinl-Pfalz 41: 377–382Google Scholar
  4. 4.
    Kipfmüller K, Bueß G, Naruhn M, Bätz W (1989) Die endoskopisch-mikrochirurgische Dissektion der Speiseröhre. Tierexperimentelle Studie. Chirurg 60: (in press)Google Scholar
  5. 5.
    Kipfmüller K, Bueß G, Naruhn M, Duda D, Melzer A, Kessler S (1989) Die endoskopisch-mikrochirurgische Dissektion der Speiseröhre (EMDÖ) — tierexperimentelle Ergebnisse. In: Bueß G (ed) Endoskopische Techniken. Deutscher Ärzte-Verlag, Köln, (in press)Google Scholar
  6. 6.
    Larrieu H, Millat B, Gayral F (1985) Oesophagectomies transhiatales. Chirurgie 111: 835–836Google Scholar
  7. 7.
    Liebermann-Meffert D, Luescher U, Neff U, Rüedi T, Allgöwer M (1987) Esophagectomy without thoracotomy: is there a risk of intramediastinal bleeding? Ann Surg 206: 184–192Google Scholar
  8. 8.
    McCullagh M, Edwards MH (1988) How vulnerable is the recurrent laryngeal nerve in esophageal surgery. In: Siewert JR, Hölscher AH (eds) Diseases of the esophagus. Springer, Berlin Heidelberg New York, pp 443–446Google Scholar
  9. 9.
    Müller JM, Jarczyk AJ, Huber P, Pichlmaier H (1988) Ergebnisse der Resektion der Speiseröhre wegen eines Karzinoms. Chirurg 59: 398–406Google Scholar
  10. 10.
    Orringer MB (1984) Technical aids in performing transhiatal esophagectomy without thoracotomy. Ann Thorac Surg 38: 128–132Google Scholar
  11. 11.
    Orringer MB (1985) Transhiatal esophagectomy for benign disease. J Thorac Cardiovasc Surg 90: 649–655Google Scholar
  12. 12.
    Orringer MB (1987) Transhiatal esophagectomy for esophageal carcinoma. In: Siewert JR, Hölscher AH (eds) Diseases of the esophagus. Springer, Berlin Heidelberg New York, pp 390–393Google Scholar
  13. 13.
    Röher HD, Linn RM, Stahlknecht CD, Thon K (1988) Zur operativen Verfahrenswahl beim Oesophaguscarcinom. Chirurg 59: 582–586Google Scholar
  14. 14.
    Shahian DM, Neptune WB, Ellis H, Watkins E (1986) Transthoracic versus extrathoracic esophagectomy: mortality, morbidity, and long-term survival. Ann Thorac Surg 41: 237–246Google Scholar
  15. 15.
    Siewert JR (1988) Leistungen der Tumorchirurgie bei Tumoren der Speiseröhre. Langenbecks Arch Chir [Suppl II]: 119–126Google Scholar
  16. 16.
    Siewert JR, Roder JD (1987) Chirurgische Therapie des Plattenepithelcarcinoms des Oesophagus — erweiterte Radikalität. Langenbecks Arch Chir 372: 129–139Google Scholar
  17. 17.
    Siewert JR, Hölscher AH, Horvath ÖP (1986) Transmediastinale Oesophagektomie. Langenbecks Arch Chir 367: 203–213Google Scholar
  18. 18.
    Terz JJ, Beatty JD, Kokal WA, Wagman LD (1987) Transhiatal esophagectomy. Am J Surg 154: 42–48Google Scholar
  19. 19.
    Turner GG (1936) Carcinoma of the oesophagus. The question of its treatment by surgery. Lancet I: 67–72, 130–134Google Scholar
  20. 20.
    Ulrich B, Kasperk R, Grabitz K, Kremer K (1985) Die Oesophagusresektion ohne Thoracotomie beim Carcinom. Chirurg 56: 251–260Google Scholar

Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • K. Kipfmüller
    • 1
  • M. Naruhn
    • 2
  • A. Melzer
    • 2
  • S. Kessler
    • 2
  • G. Bueß
    • 2
  1. 1.Labor für Endoskopische MikrochirurgieKlinik und Poliklinik für Abdominal- und AllgemeinchirurgieMainzGermany
  2. 2.Klinik und Poliklinik für Abdominal- und AllgemeinchirurgieJohannes Gutenberg-UniversitätMainzGermany

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