Endoscopic Esophagectomy: A Better Way to Atraumatic Surgery?

Abstract

This paper describes the technique and clinical results of endoscopic dissection (endodissection) of the thoracic esophagus during transhiatal esophagectomy (THE). The method eliminates the ‘blind angle’ of conventional THE and reduces intraoperative traction on mediastinal tissues. Mediastinal structures such as the trachea, main bronchi and mediastinal nerves can be identified, and bleeding from minor mediastinal vessels can be controlled under vision. The mortality rate of the first 30 patients operated on was 6.6%, and only two major intraoperative complications occurred (one lesion of the right main bronchus, 2 bleedings). The rate of recurrent nerve palsy in these patients was low (6.6%).