Laparoscopic and Thoracoscopic Ivor Lewis Esophagectomy With Colonic Interposition Ninh T. Nguyen, MD, FACS, Marcelo Hinojosa, MD, Christine Fayad, BS,

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Presentation transcript:

Laparoscopic and Thoracoscopic Ivor Lewis Esophagectomy With Colonic Interposition Ninh T. Nguyen, MD, FACS, Marcelo Hinojosa, MD, Christine Fayad, BS, James Gray, BS, Zuri Murrell, MD, Michael Stamos, MD The Annals of Thoracic Surgery Volume 84, Issue 6, Pages 2120-2124 (December 2007) DOI: 10.1016/j.athoracsur.2007.03.091 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Laparoscopic esophagogastric cancer with planned level of distal resection and colonic interposition. The Annals of Thoracic Surgery 2007 84, 2120-2124DOI: (10.1016/j.athoracsur.2007.03.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Laparoscopic port position for minimally invasive extended esophagogastrectomy with colonic interposition. The Annals of Thoracic Surgery 2007 84, 2120-2124DOI: (10.1016/j.athoracsur.2007.03.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Laparoscopic mobilization of right and transverse colon with construction of an ileocolic anastomosis. The Annals of Thoracic Surgery 2007 84, 2120-2124DOI: (10.1016/j.athoracsur.2007.03.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Laparoscopic construction of the gastrocolic anastomosis. The cecum is attached to the esophageal stump in preparation of thoracic colonic pull-up. The Annals of Thoracic Surgery 2007 84, 2120-2124DOI: (10.1016/j.athoracsur.2007.03.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Schematic diagram of the extended esophagogastrectomy with colonic interposition. There are three anastomoses: (1) ileocolic anastomosis, (2) gastrocolic anastomosis, and (3) esophagocolic anastomosis. An appendectomy was performed in the right chest. Inset represents construction of the esophagocolic anastomosis using a circular stapler. The Annals of Thoracic Surgery 2007 84, 2120-2124DOI: (10.1016/j.athoracsur.2007.03.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 Postoperative upper gastrointestinal contrast study showing the colonic interposition in the right chest cavity. The Annals of Thoracic Surgery 2007 84, 2120-2124DOI: (10.1016/j.athoracsur.2007.03.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 7 Postoperative abdominal x-ray film showing the descending colon on the left with the entire small bowel on the right side of the abdomen. The Annals of Thoracic Surgery 2007 84, 2120-2124DOI: (10.1016/j.athoracsur.2007.03.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions