Endoscopic surgery of the oesophagus

Conventional surgical access to the oesophagus often requires a thoracotomy. The application of techniques borrowed from laparoscopic surgery allows transthoracic dissection of oesophagus without thoracotomy. These techniques are useful in treatment of oesophageal leiomyomas, motility disorders and iatrogenic perforations. Oesophageal resection for cancer can be accomplished using minimal access, either thoracoscopically or with the aid of an operating mediastinoscope. Whether these techniques should replace transthoracic or transhiatal oesophagectomy for most patients with cancer remains to be seen.