Mediastinal Lymphadenectomy in Decubitus-prone “Hybrid” Thoracoscopic Esophagectomy

2010 ◽  
Vol 61 (2) ◽  
pp. 153-155
Author(s):  
H. Takeuchi ◽  
T. Oyama ◽  
Y. Saikawa ◽  
R. Nakamura ◽  
T. Takahashi ◽  
...  
Keyword(s):  
Thoracoscopic Esophagectomy ◽  
Mediastinal Lymphadenectomy

scholarly journals Effective Mediastinal Lymphadenectomy for Esophageal Cancer Using Slender Tracheal Forceps in Prone Position Thoracoscopic Esophagectomy

In Vivo ◽  
2016 ◽  
Vol 30 (6) ◽  
pp. 893-898
Author(s):  
MASANOBU NAKAJIMA ◽  
MASAKAZU TAKAHASHI ◽  
YASUSHI DOMEKI ◽  
HITOSHI SATOMURA ◽  
HIROTO MUROI ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Prone Position ◽  
Thoracoscopic Esophagectomy ◽  
Mediastinal Lymphadenectomy

scholarly journals Evaluation of Mediastinal Lymphadenectomy by Minithoracotomy Assisted Thoracoscopic Esophagectomy for Esophageal Cancer.

1999 ◽  
Vol 32 (8) ◽  
pp. 2058-2063
Author(s):  
Masashi Takemura ◽  
Harushi Osugi ◽  
Taigo Tokuhara ◽  
Nobuyasu Takada ◽  
Hiroaki Kinoshita ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Thoracoscopic Esophagectomy ◽  
Mediastinal Lymphadenectomy

RA01.01: THORACOSCOPIC ESOPHAGECTOMY IN SEMIPRONE POSITION

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 17-18
Author(s):  
Suraj Pawar
Keyword(s):  
Conflicts Of Interest ◽  
Bronchial Artery ◽  
Lung Ventilation ◽  
Lateral Position ◽  
Posterior Mediastinum ◽  
Lateral Approach ◽  
Thoracoscopic Esophagectomy ◽  
Azygous Vein ◽  
Mediastinal Lymphadenectomy ◽  
Left Lateral Decubitus Position

Abstract Description To assess the feasibility of Thoracoscopic Esophagectomy in the Dorso-Lateral position with the intention of reducing the disadvantages and increasing the benefits of lateral approach and prone approach which are the 2 conventional approaches. Methods: Thoracoscopic Esophagectomy is routinely performed in 2 positions. The left lateral decubitus position is the commonly used position at most of the centres. However prone jack-knife position as described by Cushieri is another alternative. To combine the advantages and reduce the disadvantages of the these 2, we started performing this procedure in a Dorso-Lateral position since 1st October 2008. This is a position midway between the Lateral and Prone position i.e. Left lateral position with an inclination making an angle of 45 degrees with the horizontal. Operating Surgeon and assistant are positioned anteriorly facing the ventral aspect of the patient. A three-port approach is taken with port placements in the 5th, 7th and 9th intercostals spaces in the posterior, mid and anterior axillary lines. Pneumothorax is created with CO2 pressure of 5–7 mm Hg. Although single lung ventilation is preferable the procedure can be done with routine dual lung ventilation with a 4th port being used to retract the lung if necessary. Esophagus is mobilized en-block with posterior mediastinal lymphadenectomy. The Azygous vein and right Bronchial artery are preferably preserved to maintain vascularity of right bronchus. Following this patient is turned supine and Stomach mobilization and coeliac dissection is done laparoscopically. Left neck incision is taken and esophagus is divided in the neck. Specimen is delivered in the abdomen and extra-corporeally through a mini-laparotomy. Gastric tube is prepared and brought in the neck through posterior mediastinum underneath the azygous vein and rt.bronchial artery for anastamosis in the neck. The video shows the procedure in the Dorso-Lateral Position as we routinely perform at our centre. Conclusion: Thoracoscopic Esophagectomy with Mediastinal Lymphadenectomy in the Dorso-Lateral position is a feasible, more convenient and a safe option which can combine the benefits of the conventional left lateral and prone approaches. Surgeon comfort is enhanced in terms of more comfortable operating position and improved ergonomics. Disclosure All authors have declared no conflicts of interest.

scholarly journals The hybrid position is superior to the prone position for thoracoscopic esophagectomy with upper mediastinal lymphadenectomy

2020 ◽  
Vol 5 ◽  
pp. 13-13
Author(s):  
Hirotoshi Kikuchi ◽  
Yoshihiro Hiramatsu ◽  
Tomohiro Matsumoto ◽  
Wataru Soneda ◽  
Sanshiro Kawata ◽  
...  
Keyword(s):  
Prone Position ◽  
Thoracoscopic Esophagectomy ◽  
Mediastinal Lymphadenectomy

Iatrogenic thoracic aortic injury in esophagectomy – a case report and literature review

2019 ◽  
Vol 98 (6) ◽  
pp. 256-259
Keyword(s):  
Case Report ◽  
Minimally Invasive ◽  
Thoracic Aorta ◽  
Aortic Rupture ◽  
Hypovolemic Shock ◽  
Left Lung ◽  
Aortic Injury ◽  
Thoracoscopic Esophagectomy ◽  
Neoadjuvant Radiochemotherapy ◽  
Thoracic Aortic Injury

Introduction: This case report describes bleeding from an iatrogenic thoracic aortic injury in minimally invasive thoracoscopic esophagectomy. Case report: A 53-year-old man underwent neoadjuvant radiochemotherapy for adenocarcinoma of the esophagus with positive lymph nodes. PET/CT showed only a partial response after neoadjuvant therapy. Minimally invasive thoracoscopic esophagectomy in the semi-prone position with selective intuba- tion of the left lung was performed. However, massive bleeding from the thoracic aorta during separation of the tumor resulted in conversion from minimally invasive to conventional right thoracotomy. The bleeding was caused by a five millimeter rupture of the thoracic aorta. The thoracic aortic rupture was treated by suture with a gore prosthesis in collaboration with a vascular surgeon. Esophagestomy was not completed due to hypovolemic shock. Hybrid transhiatal esophagectomy was performed on the seventh day after the primary operation. Definitive histological examination showed T3N3M0 adenocarcinoma. Conclusion: Esophagectomy for cancer of the esophagus is one of the most difficult operations in general surgery in which surgical bleeding from the surrounding structures cannot be excluded. Aortic hemorrhage is hemodynamically significant in all cases and requires urgent surgical treatment.

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