This video illustrates the preferred technique for minimally invasive esophagectomy at the University of Pittsburgh. Previously, our described technique included mobilization of the esophagus via thoracoscopy, laparoscopic creation of the gastric tube and construction of a cervical esophagogastric anastomosis. Although we have reported excellent outcomes with this technique, we have since modified the procedure to an Ivor Lewis esophagectomy, in which the anastomosis is constructed within the chest.
The benefits of avoiding a cervical incision include: 1) minimizing the risk of injury to the recurrent laryngeal nerves and 2) a reduced incidence of anastomotic leak. The technique is appropriate for patients with either high-grade dysplasia or carcinoma involving the distal esophagus or GE junction. We do not employ this approach for patients with mid-esophageal tumors.
The video details this refinement in our technique of minimally invasive esophagectomy. Technical considerations of constructing a thoracoscopic esophageal anastomosis are emphasized.
Session: Podium Video Presentation
Program Number: V038