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Thoracoscopic Extended Right Middle Plus Lower Sleeve Lobectomy for Non-Small-Cell Lung Cancer

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Published on: February 27, 2026

Thoracoscopic Intrathoracic Double-Flap Technique for EGJC.

Takeshi Ono¹, Yorito Tamaki¹, Takano Ohta¹

¹Department of Surgery, Nakagami Hospital, Okinawa, Japan.

JSLS : Journal of the Society of Laparoendoscopic Surgeons

|June 12, 2026

Summary

This summary is machine-generated.

Thoracoscopic intrathoracic double-flap technique (DFT) is a feasible and reproducible method for esophagogastrostomy after esophagogastric junction cancer surgery. This minimally invasive approach offers a safe option for mediastinal reconstruction with no observed complications.

Keywords:

Double-flap technique Esophagogastric junction cancer Intrathoracic esophagogastrostomy Proximal gastrectomy Thoracoscopic surgery

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

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

Published on: September 11, 2021

Area of Science:

Minimally invasive surgery
Surgical oncology
Gastrointestinal surgery

Background:

Valvuloplastic esophagogastrostomy using the double-flap technique (DFT) is effective for reflux prevention and has a low anastomotic leakage rate.
Intrathoracic reconstruction is a safer option when the transhiatal approach is difficult for esophagogastric junction cancer (EGJC).
Thoracoscopic intrathoracic DFT has been reported in isolated cases, with limited evaluation of its feasibility and reproducibility.

Purpose of the Study:

To evaluate the technical feasibility and reproducibility of thoracoscopic intrathoracic DFT for mediastinal esophagogastrostomy.
To assess the safety and efficacy of this technique in a case series.

Main Methods:

A consecutive six-patient case series of thoracoscopic intrathoracic DFT following laparoscopic proximal gastrectomy and lower esophagectomy.
Preparation of a seromuscular flap and elevation of the remnant stomach into the thoracic cavity.
Posterior esophageal wall fixation, 90° rotation, and completion of a full-circumference hand-sewn esophagogastrostomy.

Main Results:

All procedures were completed thoracoscopically without conversion.
The median reconstruction time was 78 minutes.
No anastomosis-related complications were observed.

Conclusions:

Thoracoscopic intrathoracic DFT is technically feasible and reproducible for mediastinal esophagogastrostomy.
Standardized exposure with posterior fixation and 90° rotation enables stable suturing.
This technique supports the safe application of valve-forming reconstruction in the thoracic cavity.