Atsushi Urakami
   Department   Kawasaki Medical School  Kawasaki Medical School, Department of General Surgery,
   Position   Professor with Special Assignment
Language English
Conference 21st International Congress of the European Association for Endoscopic Surgery
Conference Type International society and overseas society
Publisher and common publisher◎Shigemitsu Kaori, Hirabayashi Yoko, Takaoka Munenori, Fukazawa Takuya, Hayashi Jiro, Urakami Atsushi, Yoshida Kazuhiro, Yamatsuji Tomoki, Nakashima Kazutaka, Morita Ichiro, Naomoto Yoshio
Date 2013/06/19
(city and name of the country)
Vienna, Austria
Summary In recent years, with the spread of thoracoscopic esophagectomy has also diversified its procedures. There is a prone position and the left lateral decubitus position as a representative, with the presence or absence of pneumothorax. Advantages of the prone position are that it does not require a mastery of the assistant, and a good viewing in dissection of the middle and lower mediastinal lymph nodes. The advantages of the left lateral decubitus position are that the good viewing in dissection of the upper mediastinal lymph nodes as well as open-thorasic surgery is obtained and that it is easy to support unexpected conditions, such as bleeding, and the like. At our institution, in introducing thoracoscopic esophagectomy in May 2012, the first to ensure the safety, we adopt the left lateral decubitus position with pneumothorax which does not require a mastery of assistant. Using 2 monitors reversing, both surgeon and assistant can obtain the eye-hand coodination simultaneously As carbon dioxide is introduced into the intrathorasic space, we can obtain good surgical view. We show the point of the procedure of thracoscopic esophagectomy with lymphadenectomy, such as dissection of recurrent nerve lymph nodes, in the left lateral decubitus position with pneumothorax. We performed thoracoscopic esophagectomy for 7 patients with esophageal cancer from May 2012 to January 2013 with no major postoperative or intraoperative complications. Postoperative hospital stay was shorter in the patients treated with thoracoscopic esophagectomy in comparison with those treated with open esophagectomy.