Laparoscopic Transhiatal Esophagectomy

Transhiatal esophagectomy is essentially performed for cancers of the lower one third of esophagus or tumors at the gastro-esophageal junction.

Laparoscopic transhiatal esophagectomy has converted an essentially blind procedure in to a directly visualized procedure wherein every step can be well demonstrated. The magnification helps to achieve the precise planes of dissection with minimal chances of damaging the pleura. During preparation of the conduit, there is less handling of the stomach, so a laparoscopically mobilized stomach tube is better vascularized.

CO₂ insufflation facilitates mediastinal dissection; the direct branches of the aorta to the esophagus are clearly identified and clipped. Therefore the chances of bleeding are minimized. The thoracic duct is also clipped, hence chylous leaks are minimized.