Endoscopic subtotal oesophagectomy for cancer using the right thoracoscopic approach

The technique of right thoracoscopic oesophagectomy and our experience with this approach are reviewed. The procedure enables resection of middle and lower third tumours with lymphadenectomy which is equivalent to that achieved by the standard McKeown operation. Thoracoscopic inspection with biopsy detects small pleural deposits which are missed by the standard preoperative tests including CT scanning. The initial experience with endoscopic oesophagectomy has been favourable in terms of recovery and time spent in the intensive care unit, although the procedure takes significantly longer than the equivalent open dissection of the thoracic oesophagus.