Aurelio Francisco Aranzana Gomez, Jara Hernandez Gutierrez, Juan Malo Corral, Soledad Buitrago Sivianes, Rafael Lopez Pardo, Beatriz Muñoz Jimenez. Hospital Virgen De La Salud, Toledo
Objectives: We present a video that shows the thoracoscopic time of esophagectomy in three fields. To demonstrate the safety and efficacy of the minimally invasive approach in patients with malignant oesophageal pathology that require a total esophagectomy in three fields. The advantages of performing this technique is the reduction of blood loss, decreased postoperative stay, lower morbidity and mortality than in conventional surgery, better analgesic control, smaller incisions minimizing operative aggression, favors the patient's subsequent recovery and increases their quality of life. All these advantages have to be supported by an adequate selection of patients and an excellent preparation of the surgical team with extensive knowledge in laparoscopic surgery.
Results: We present a video that shows the standardized thoracoscopic time of a total esophagectomy. The position in prone position during thoracoscopy facilitates the vision of the structures and an adequate lung disposition without need of a separator.
Intervention: Prone decubitus, selective intubation. Approach by right thoracoscopy, 4 trocars. En bloc esophageal mobilization, including perisophageal pleura, with periesophageal, periaortic, peribronchial and subcarinal mediastinal lymphadenectomy, azygos vein section, resection and clipping of the duct thoracic, endothoracic drainage. The surgery is continued with a laparo- scopic and left lateral cervical approach completing the proximal esophago- gastrectomy with gastric esophago-tubular cervical anastomosis.
Conclusions: The minimally invasive surgery of esophageal cancer, by means of right thoracoscopy and prone decubitus is a valid and safe alternative to traditional surgery, and should be done in a standardized way and by teams with experience in this type of approach.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94741
Program Number: V254
Presentation Session: Video Loop Day 2
Presentation Type: VideoLoop