Esophagectomy remains a major resection posing a great burden to both patients’ safety and quality of life as well as to medical resources. The wish to minimize perioperative risk and accelerate patients’ return to normal life is a driving force for technical as well as organizational improvement.
Key words: esophagectomy, MIE, VATS
Advantages and drawbacks of minimally invasive techniques for esophagectomy are discussed. Oncological principles are highlighted and crucial phases of the resection reviewed. Prerequisites regarding previous experience and instrumentation are discussed before implementing a comprehensive minimally invasive esophagectomy programme.
We report our institutions experience since starting the programme 26 months ago. In this period 47 esophagectomies for esophageal or esophagogastric junction cancers were performed. In the first half of this period 11 open, 1 complete minimally invasive (MIE) and 16 hybrid (laparotomy+VATS) esophagectomies were performed (17/28) and in the second half 2 open, 3 MIE and 12 hybrid procedures (15/17).
Minimally invasive esophagectomy is a complex procedure with a steep learning curve. However, in a setting with extensive previous experience with open esophageal as well as various other minimally invasive thoracic and abdominal procedures its implementation is simple, feasible and safe.
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