Totally endoscopic Ivor Lewis esophagectomy

Esophagectomy is associated with significant risks of perioperative morbidi ty and mortality, as well as prolonged convalescence due to effects of the incisions used for conventional surgical access. Because the outcome of thi s procedure is palliative in the majority of patients, it is possible that laparoscopic techniques could improve initial postoperative outcomes and th erefore make surgery more acceptable for patients with esophageal cancer. A new technique is described for Ivor Lewis esophagectomy, which incorporate s a hand-assisted laparoscopic approach for gastric mobilization and a thor acoscopic approach for esophageal dissection and anastomosis. Initial exper ience in two patients has been encouraging, with postoperative hospital sta y and convalescence shortened.