Minimally invasive Ivor Lewis esophagectomy can be performed with low morbidity and is the preferred operation for gastroesophageal junction tumors at our institution. We inject botulinum toxin into the pylorus endoscopically rather than performing pyloromyotomy or pyloroplasty. The gastric conduit is created laparoscopically. Lymph nodes at the base of the left gastric artery and celiac trunk are removed and a feeding jejunostomy catheter is routinely placed. The chest portion of the operation is performed robotically, mobilizing the esophagus and performing a complete mediastinal and paraesophageal lymphadenectomy. The anastomosis is made with a circular stapler at the level of the azygos vein and an omental flap is interposed between the anastomosis and the trachea.
- Ivor Lewis
- Minimally invasive