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Thoracoscopic Radical Esophagectomy for Cancer

  • Harushi OsugiEmail author
  • Kousuke Narumiya
  • Kenji Kudou
Chapter
  • 593 Downloads

Abstract

Since the first report by Dallemagne in the left lateral position in 1991 and by Cuschieri in the prone position in 1992, the minimally invasive oesphagectomy for cancer has been becoming popular gradually and been performed widely. For oesophageal cancer, the same quality of mediastinal dissection as open surgery should be entailed even through thoracoscopy. However, after learning in the technique, the previously undescribed fine anatomy, namely microanatomy, became obvious under magnified view obtained by positioning the camera at close vicinity to the dissection and thoracoscopic surgeon’s knowledge of the layer structure in the mediastinum became profounder. The proper dissection along the anatomical layer minimizes the tissue damage, bleeding and duration of the procedure, without oncological compromise. Reducing surgical insulation in the mediastinum by the rational dissection along the anatomical layers is the important factor in minimally invasive surgery together with reducing the thoracic wound.

Keywords

Thoracoscopy Oesophagus Oesophagectomy Cancer Recurrent nerves Lymphadenectomy 

Supplementary material

Video 7.1

Esophageal resection by lateral thoracoscopy. Supracarinal lymphadenectomy along recurrent laryngeal nerves. After dissection (WMV 10541 kb)

Video 7.2

Esophageal resection by lateral thoracoscopy. Supracarinal lymphadenectomy along recurrent laryngeal nerves. Aortic arch nodes (WMV 12709 kb)

Video 7.3

Esophageal resection by lateral thoracoscopy. Supracarinal lymphadenectomy along recurrent laryngeal nerves. Bifurcation nodes (WMV 46534 kb)

Video 7.4

Esophageal resection by lateral thoracoscopy. Supracarinal lymphadenectomy along recurrent laryngeal nerves. Left recurrent node (WMV 33284 kb)

Video 7.5

Esophageal resection by lateral thoracoscopy. Supracarinal lymphadenectomy along recurrent laryngeal nerves. Right recurrent node (WMV 19905 kb)

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of SurgeryInstitute of Gastroenterology, Tokyo Women’s Medical UniversitySinju-kuJapan

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