caa a22 4500 445334886 CHVBK 20180317142751.0 cr unu---uuuuu 170323e20110301xx s 000 0 eng 10.1245/s10434-010-1330-7 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1330-7 Thoracoscopic Esophagectomy in Prone Position [Elektronische Daten] [Guy Cadière, Giovanni Dapri, Jacques Himpens, Amin Rajan] Introduction: Esophagectomy can be performed by different minimal invasive techniques. We report a technique of Ivor Lewis esophagogastrectomy with manual anastomosis performed by thoracoscopy in prone position. Readers are encouraged to view the streaming video that accompanies this article. Case report: A 51-year-old man was consulted for adenocarcinoma of the distal esophagus without lymph nodes invasion. Anesthesia was realized using a double-lumen endotracheal tube. The procedure started with the patient supine, and five abdominal trocars were placed. Celiac lymphadenectomy, wide Kocher maneuver, and pyloroplasty were performed. A wide gastric tube was advanced through the hiatus into the right chest. Subsequently the patient was placed in prone position and three trocars (two 5-mm, one 10-mm) were placed in the 5th, 7th, and 9th right intercostal space. The intrathoracic esophagus was dissected, and mediastinal lymphadenectomy with en bloc resection of the left inferior mediastinal pleura was performed. After sectioning the azygos vein, the esophagus was transected by scissors 1cm cranially. A completely thoracoscopic manual double-layer anastomosis was performed using running sutures with PDS 2/0 (externally) and Maxon 4/0 (internally). Finally the patient was replaced supine; the gastric tube was fixed to the hiatus, and the specimen was retrieved by suprapubic incision. Results: Thoracoscopy lasted 157' (anastomosis 40'), laparoscopy 160', and second laparoscopy 20'. Blood loss was 170cc. The patient was discharged on postoperative day 6. Conclusions: Thoracoscopy in prone position allows the surgeon to perform a thoracoscopic esogastric anastomosis completely manually using only three trocars and without selective lung desufflation. Society of Surgical Oncology, 2010 Cadière Guy Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium aut Dapri Giovanni Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium aut Himpens Jacques Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium aut Rajan Amin Department of Gastroenterology and Endoscopy, CHIREC, Brussels, Belgium aut Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 838-838 1068-9265 18:3<838 2011 18 10434 https://doi.org/10.1245/s10434-010-1330-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1330-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Cadière Guy Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium aut NATIONALLICENCE 700 1- Dapri Giovanni Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium aut NATIONALLICENCE 700 1- Himpens Jacques Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, Brussels, Belgium aut NATIONALLICENCE 700 1- Rajan Amin Department of Gastroenterology and Endoscopy, CHIREC, Brussels, Belgium aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/3(2011-03-01), 838-838 1068-9265 18:3<838 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer