Video-assisted thoracoscopic surgery (VATS) uniportal intrathoracic esophagectomy
Uniportal video-assisted thoracoscopic surgery (VATS) for esophagectomy is becoming popular and several papers have been published in recent years. Our approach is through a 5th or 6th intercostal space on the posterior axillary line and direct view of the posterior mediastinum is possible. Technical details include en bloc dissection of the esophagus with lymph nodes taking pericardium and aorta as the anatomic guides. Azygos vein is divided. Anastomotic technique is based on a double barrel principle with a posterior wall and lateral wall closure using linear staplers. In recent papers results of uniportal VATS esophagectomy are comparable with multiport VATS and open approach in terms of bleeding, oncologic adequacy and operation times. Uniportal VATS intrathoracic esophagectomy is utilized more frequently and despite differences of technical peculiarities in initial reports, it appears to be feasible and applicable in most of the cases.