Thoracoscopic oesophagectomy

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Abstract
Eight patients with gastro-oesophageal cancer underwent thoraco-scopically assisted total oesophagectomy using the prone position. This allowed good exposure of the mediastinum and ventilation of both lungs could be continued throughout the operation. The median time for oesophageal mobilization was 150 min. The only operative complication was a contralateral pneumothorax which was treated uneventfully. Patients were then placed in the supine position and a standard R2 dissection of the stomach performed with a gastro-oesophageal anastomosis in the neck. The technique offers potential advantages over thoracoscopic mobilization of the oesophagus in the supine position. The operation and preliminary results are discussed.