Minimally Invasive Esophagectomy with the Transoral EEA Stapler: Part I

The video demonstrates the hand port technique for the gastric mobilization phase of a minimally invasive Ivor Lewis esophagectomy. The author prefers this technique for a number of reasons. The hand port allows for tactile feedback not obtained through laparoscopic instruments. This is advantageous in patients with celiac nodal disease, where the surgeon can ensure, through palpation, the maximal amount of nodal tissue in the specimen. It also facilitates resident education and participation in the operation, as the anatomy is fairly straightforward. It has the advantage of a minimally invasive technique, including ligation and division of the short gastric vessels, and an excellent view into the mediastinum for the distal esophageal dissection. Leaving sponges and a Penrose drain at the completion of this portion of the operation facilitates the subsequent chest phase.

View Part II here.