• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Lymphnode Dissection along the Left Recurrent Laryngeal Nerve after Esophageal Stripping and Modified Circular Stapling for Safe Anastomotsis in VATS-E.

Lymphnode Dissection along the Left Recurrent Laryngeal Nerve after Esophageal Stripping and Modified Circular Stapling for Safe Anastomotsis in VATS-E.

Hiroshi Makino1, Hiroshi Yoshida, PhD2, Hiroshi Maruyama1, Tadashi Yokoyama1, Atsushi Hirakata1, Junji Ueda1, Hideyuki Takata1, Yuta Kikuchi1, Takuma Iwai1, Masafumi Yoshioka1, Nobuyuki Sakurazawa3, Tsutomu Nomura2. 1Department of Surgery, Nippon Medical School, Tama-Nagayama Hospital, 2Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, 3Department of Surgery, Nippon Medical School, Chiba-Hokusoh Hospital

Background: The working space in the upper mediastinum is limited and lymph-node(L.N.) dissection along the left recurrent laryngeal nerve is difficult despite of a clear operative view of the middle and lower mediastinum in prone position VATS-E(Video-Assisted Thoracoscopic Surgery of Esophagus). Anastomosis by a circular stapler in the narrow neck field is difficult. We report our technique of the L.N. dissection along the left recurrent laryngeal nerve and safe anastomosis.

Methods: 

-Patients:

One hundred thirty patients (27 in left lateral and 103 in prone position), with esophageal carcinomas underwent VATS-E, respectively.

-Methods:

VATS-E in prone position: At first the patients are fixed at semi-prone position and esophagectomy is performed in prone position that can be set by rotating and 5 ports are used at the intercostal space (ICS). Esophagectomy and the L.N. dissection are performed with pneumothorax by maintaining CO2 insufflation.

L.N. dissection around left recurrent laryngeal nerve: Working space at the left upper mediastinal area for L.N. dissection around recurrent laryngeal nerve is limited in prone position. To obtain the space the residual esophagus is stripped in the reverse direction and retracted toward the neck after the stomach tube is removed through the nose.

Anastomosis: At first the circular stapler is introduced into the gastric conduit and joined to an anvil, and close a little. And then a joined anvil is placed into the proximal esophagus and secured by means of a pursestring suture. The gastric conduit opening is closed by a linear stapler, and the anastomosis is completed.

Results:

1. The rate of permanent and transient recurrent laryngeal nerve paralysis were 2.6% and 22%, respectively.

2. The rate of anastomotic leak and postoperative pneumonia was 4.0% and 2.9%,

Discussion:

1. L.N. dissection along the left recurrent laryngeal nerve after esophageal stripping is available in prone position of VATS-E.

2. Our anastomotic technique is safe.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 93629

Program Number: P455

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

View this Poster

16

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals