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Related Concept Videos

Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

Endoscopic Studies I: Bronchoscopy and Thoracoscopy

Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due to...

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Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer
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Laparoscopic and thoracoscopic esophagectomy.

Ryan M Levy1, Joseph Wizorek, Manisha Shende

  • 1Department of Surgery, Division of Thoracic and Foregut Surgery, Heart, Lung and Esophageal Surgery Institute, University of Pittsburgh, 200 Lothrop Street Suite C-800, Pittsburgh, PA 15213, USA.

Advances in Surgery
|October 6, 2010
PubMed
Summary

Minimally invasive esophagectomy (MIE) techniques have evolved, with the laparoscopic-thoracoscopic Ivor Lewis approach now preferred. This method reduces complications like recurrent nerve injury and improves outcomes compared to previous MIE methods.

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Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy
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Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy

Published on: September 11, 2021

Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Minimally invasive esophagectomy (MIE) techniques have evolved over the past decade.
  • Early laparoscopic approaches had limitations in visualization and dissection.
  • Transition to laparoscopic-thoracoscopic McKeown approach improved outcomes but had cervical dissection challenges.

Purpose of the Study:

  • To describe the evolution of MIE techniques.
  • To highlight the advantages of the laparoscopic-thoracoscopic Ivor Lewis esophagectomy.
  • To compare outcomes of different MIE approaches.

Main Methods:

  • Review of experience with over 500 minimally invasive esophagectomies.
  • Comparison of totally laparoscopic, laparoscopic-thoracoscopic McKeown, and totally thoracoscopic-laparoscopic Ivor Lewis approaches.
  • Analysis of perioperative morbidity, mortality, and specific complications.

Main Results:

  • The laparoscopic-thoracoscopic McKeown approach reduced perioperative morbidity and mortality compared to open surgery.
  • Cervical dissection in the McKeown approach led to recurrent laryngeal nerve injuries and anastomotic issues.
  • The totally thoracoscopic-laparoscopic Ivor Lewis esophagectomy eliminated recurrent nerve injury and showed promising results.

Conclusions:

  • Laparoscopic-thoracoscopic Ivor Lewis esophagectomy is the preferred MIE approach due to reduced complications and comparable outcomes.
  • This technique offers advantages including zero recurrent nerve injury rate and potentially improved gastric resection margins.
  • Further data is needed to confirm oncologic outcomes and long-term results.