Laparoscopic and Thoracoscopic Transhiatal Esophagectomy with Cervical Anastomosis

  • Moshim KukarEmail author
  • Steven N. Hochwald


In this chapter, we will outline our technique for laparoscopic and thoracoscopic transhiatal esophagectomy with cervical anastomosis. We utilize this technique routinely in patients with esophageal and Siewert’s types 1 and 2 gastroesophageal junction cancer. This technique has been shown to be safe in the setting of neoadjuvant chemoradiation since most patients in the western world present with locally advanced carcinoma and receive multimodality treatment. This technique is best reserved for those patients who have no history of previous gastric surgery such as a Nissen fundoplication. In such patients, the amount of gastric conduit available to reach the neck may be limited and an intrathoracic esophagogastric anastomosis may be preferable as described in other portions of this book.


Recurrent Laryngeal Nerve Staple Line Gastric Conduit Left Gastric Vein Left Crus 
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Supplementary material

Video 13.1

Minimally invasive esophagectomy with cervical anastomosis: Thoracoscopic dissection (MOV 399814 kb)

Video 13.2

Minimally invasive esophagectomy with cervical anastomosis: Cervical dissection (MOV 118635 kb)

Video 13.3

Minimally invasive esophagectomy with cervical anastomosis: Abdominal dissection (MOV 301030 kb)

Video 13.4

Minimally invasive esophagectomy with cervical anastomosis: Reconstruction (MOV 159164 kb)


  1. 1.
    Hochwald SN, Ben-David K. Minimally invasive esophagectomy with cervical esophagogastric anastomosis. J Gastrointest Surg. 2012;16(9):1775–81.PubMedCrossRefGoogle Scholar
  2. 2.
    Ben-David K, Sarosi GA, Cendan JC, Howard D, Rossidis G, Hochwald SN. Decreasing morbidity and mortality in 100 consecutive minimally invasive esophagectomies. Surg Endosc. 2012;26(1):162–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Ben-David K, Rossidis G, Zlotecki RA, Grobmyer SR, Cendan JC, Sarosi GA, Hochwald SN. Minimally invasive esophagectomy is safe and effective following neoadjuvant chemoradiation therapy. Ann Surg Oncol. 2011;18(12):3324–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Kukar M, Hochwald SN. Operative and multimodal aspects of esophago-gastric junction (EGJ) cancer care: western viewpoints. Textbook of complex general surgical oncology (in press).Google Scholar
  5. 5.
    Shen Y, Feng M, Khan MA, Wang H, Tan L, Wang Q. A simple method minimizes chylothorax after minimally invasive esophagectomy. J Am Coll Surg. 2014;218(1):108–12.PubMedCrossRefGoogle Scholar
  6. 6.
    Ben-David K, Kim T, Caban AM, Rossidis G, Rodriguez SS, Hochwald SN. Pre-therapy laparoscopic feeding jejunostomy is safe and effective in patients undergoing minimally invasive esophagectomy for cancer. J Gastrointest Surg. 2013;17(8):1352–8.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Surgical OncologyRoswell Park Cancer InstituteBuffaloUSA

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