Abstract
Beginning with the widespread introduction of laparoscopic cholecystectomy in late 1989, minimally invasive surgical technique has been refined in conjunction with the development of advanced instrumentation and have subsequently been applied to increasingly complicated disease processes. Esophageal surgeons have increasingly incorporated minimally invasive surgery into their practice since the first laparoscopic fundoplication was described by Dallemagne et al. in 1991. Esophagectomy is associated with significant morbidity and mortality even in highly experienced centers. Many esophageal surgeons have had a great deal of interest in minimally invasive esophagectomy (MIE), which has the potential advantages of being a less traumatic procedure with a resultant improvement in postoperative convalescence and fewer wound and cardiopulmonary complications compared to the open approaches. Throughout the 1990s, as confidence with laparoscopic surgery of the esophagogastric junction grew, MIE was initially attempted with hybrid operations combining traditional open surgery with minimally invasive approaches. Subsequently, a totally laparoscopic transhiatal approach was described; however, this approach was perceived to be very challenging and has not gained widespread acceptance. Approaches used at present depend on cancer stage, cancer location, body habitus, and pulmonary function. For localized cancer (T1N0) or HGD, we prefer laparoscopic inversion esophagectomy (retrograde or antigrade). This approach may also be used for patients at high risk for thoracotomy. For locally advanced cancer in the middle third of the esophagus or for proximal third esophageal cancer, we prefer 3-field MIE (abdomen, and chest with neck anastomosis). For locally advanced cancer in the distal esophagus, especially in patients with a short thick neck, we prefer thoracoscopic-laparoscopic (2-field) esophagectomy (TLE).
Similar content being viewed by others
References
Vierra M (1995) Minimally invasive surgery. Annu Rev Med 46:147–158
Dallemagne B, Weerts JM, Jehaes C et al (1991) Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc 1:138–143
Ackroyd R, Watson DI, Majeed AW et al (2004) Randomized clinical trial of laparoscopic versus open fundoplication for gastro-oesophageal reflux disease. Br J Surg 91:975–982
DeMeester TR, Bonavina L, Albertucci M (1986) Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. Ann Surg 204:9–20
Hunter JG, Trus TL, Branum GD et al (1996) A physiologic approach to laparoscopic fundoplication for gastroesophageal reflux disease. Ann Surg 223:673–685 discussion 685–677
Khajanchee YS, Kanneganti S, Leatherwood AE et al (2005) Laparoscopic Heller myotomy with Toupet fundoplication: outcomes predictors in 121 consecutive patients. Arch Surg 140:827–833 discussion 833–824
Patti MG, Pellegrini CA, Horgan S et al (1999) Minimally invasive surgery for achalasia: an 8-year experience with 168 patients. Ann Surg 230:587–593 discussion 593–584
Millikan KW, Silverstein J, Hart V et al (1995) A 15-year review of esophagectomy for carcinoma of the esophagus and cardia. Arch Surg 130:617–624
Orringer MB, Marshall B, Iannettoni MD (1999) Transhiatal esophagectomy: clinical experience and refinements. Ann Surg 230:392–400 discussion 400–393
Atkins BZ, Shah AS, Hutcheson KA et al (2004) Reducing hospital morbidity and mortality following esophagectomy. Ann Thorac Surg 78:1170–1176 discussion 1170–1176
Collard JM, Lengele B, Otte JB et al (1993) En bloc and standard esophagectomies by thoracoscopy. Ann Thorac Surg 56:675–679
Akaishi T, Kaneda I, Higuchi N et al (1996) Thoracoscopic en bloc total esophagectomy with radical mediastinal lymphadenectomy. J Thorac Cardiovasc Surg 112:1533–1540 discussion 1540–1531
Robertson GS, Lloyd DM, Wicks AC et al (1996) No obvious advantages for thoracoscopic two-stage oesophagectomy. Br J Surg 83:675–678
DePaula AL, Hashiba K, Ferreira EA et al (1995) Laparoscopic transhiatal esophagectomy with esophagogastroplasty. Surg Laparosc Endosc 5:1–5
Swanstrom LL, Hansen P (1997) Laparoscopic total esophagectomy. Arch Surg 132:943–947 discussion 947–949
Luketich JD, Nguyen NT, Weigel T et al (1998) Minimally invasive approach to esophagectomy. JSLS 2:243–247
Watson DI, Davies N, Jamieson GG (1999) Totally endoscopic Ivor Lewis esophagectomy. Surg Endosc 13:293–297
Akiyama H, Tsurumaru M, Ono Y et al (1994) Esophagectomy without thoracotomy with vagal preservation. J Am Coll Surg 178:83–85
Perry KA, Enestvedt CK, Diggs BS et al (2009) Perioperative outcomes of laparoscopic transhiatal inversion esophagectomy compare favorably with those of combined thoracoscopic-laparoscopic esophagectomy. Surg Endosc 23:2147–2154
Luketich JD, Alvelo-Rivera M, Buenaventura PO et al (2003) Minimally invasive esophagectomy: outcomes in 222 patients. Ann Surg 238:486–494 discussion 494–485
Bizekis C, Kent MS, Luketich JD et al (2006) Initial experience with minimally invasive Ivor Lewis esophagectomy. Ann Thorac Surg 82:402–406 discussion 406–407
Jobe BA, Kim CY, Minjarez RC et al (2006) Simplifying minimally invasive transhiatal esophagectomy with the inversion approach: lessons learned from the first 20 cases. Arch Surg 141:857–865 discussion 865–856
Kent MS, Schuchert M, Fernando H et al (2006) Minimally invasive esophagectomy: state of the art. Dis Esophagus 19:137–145
Holscher AH, Schneider PM, Gutschow C et al (2007) Laparoscopic ischemic conditioning of the stomach for esophageal replacement. Ann Surg 245:241–246
Varela E, Reavis KM, Hinojosa MW et al (2008) Laparoscopic gastric ischemic conditioning prior to esophagogastrectomy: technique and review. Surg Innov 15:132–135
Schroder W, Holscher AH, Bludau M et al (2010) Ivor-Lewis esophagectomy with and without laparoscopic conditioning of the gastric conduit. World J Surg 34:738–743
Akiyama S, Kodera Y, Sekiguchi H et al (1998) Preoperative embolization therapy for esophageal operation. J Surg Oncol 69:219–223
Bhat MA, Dar MA, Lone GN et al (2006) Use of pedicled omentum in esophagogastric anastomosis for prevention of anastomotic leak. Ann Thorac Surg 82:1857–1862
Perry KA, Enestvedt CK, Pham T et al (2009) Comparison of laparoscopic inversion esophagectomy and open transhiatal esophagectomy for high-grade dysplasia and stage I esophageal adenocarcinoma. Arch Surg 144:679–684
Pham TH, Perry KA, Dolan JP et al (2010) Comparison of perioperative outcomes after combined thoracoscopic-laparoscopic esophagectomy and open Ivor-Lewis esophagectomy. Am J Surg 199:594–598
Bailey SH, Bull DA, Harpole DH et al (2003) Outcomes after esophagectomy: a ten-year prospective cohort. Ann Thorac Surg 75:217–222 discussion 222
Biere SS, Cuesta MA, van der Peet DL (2009) Minimally invasive versus open esophagectomy for cancer: a systematic review and meta-analysis. Minerva Chir 64:121–133
Nagpal K, Ahmed K, Vats A et al (2010) Is minimally invasive surgery beneficial in the management of esophageal cancer? A meta-analysis. Surg Endosc 24:1621–1629
Hulscher JB, van Sandick JW, de Boer AG et al (2002) Extended transthoracic resection compared with limited transhiatal resection for adenocarcinoma of the esophagus. N Engl J Med 347:1662–1669
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hoppo, T., Jobe, B.A. & Hunter, J.G. Minimally Invasive Esophagectomy: The Evolution and Technique of Minimally Invasive Surgery for Esophageal Cancer. World J Surg 35, 1454–1463 (2011). https://doi.org/10.1007/s00268-011-1049-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-011-1049-z