CHAPTER 23 Video-Assisted Esophageal Mobilization—Video 23 Robert J. McKenna, Jr. Introduction Mobilization of the esophagus by video-assisted thoracic surgery (VATS) offers the advantage of a complete cancer operation performed with minimally invasive surgery. Although most VATS procedures are performed with the patient in the lateral decubitus position, the prone position offers several advantages for surgery on structures in the posterior mediastinum. Because gravity causes the lung to fall out of the way, lung retraction required in the lateral position is not needed when the patient is prone. Only three small incisions are needed to perform the procedure. The planes of dissection are the azygous vein, aorta, pericardium, vertebral bodies, and the trachea, allowing a thorough cancer operation with wide dissection and a complete nodal dissection to be performed. Approach to Video-Assisted Esophageal Mobilization Order of Operative Steps The order of the steps of the operation are as follows: dissect on pericardium, dissect along azygous vein and aorta, remove subcarinal nodes, clip the thoracic duct, transect the azygous vein, and dissect the esophagus at the apex of the chest. Key Points ♦ Perform esophagogastroduodenoscopy with the patient in the supine position on the gurney, and then place the patient prone on the operating table. ♦ Dissect inferiorly to superiorly in the chest. ♦ Dissect along the pericardium first, because if dissection along the azygous is done first, the esophagus falls in the way when dissecting the pericardial plane after the posterior dissection. Video-Assisted Esophageal Mobilization (Video 23) Step 1. Esophagoscopy and Positioning ♦ With the patient asleep and in the supine position on the gurney, perform esophagogastroduodenoscopy. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Thoracoscopic Sympathectomy Right Upper Lobe Anterior Segmentectomy—Video 19 Left Upper Lobe Apical Trisegmentectomy—Video 16-1 Pneumonectomy—Video 7 Stay updated, free articles. Join our Telegram channel Join Tags: Atlas of Minimally Invasive Thoracic Surgery Jun 4, 2016 | Posted by admin in CARDIAC SURGERY | Comments Off on Video-Assisted Esophageal Mobilization—Video 23 Full access? Get Clinical Tree
CHAPTER 23 Video-Assisted Esophageal Mobilization—Video 23 Robert J. McKenna, Jr. Introduction Mobilization of the esophagus by video-assisted thoracic surgery (VATS) offers the advantage of a complete cancer operation performed with minimally invasive surgery. Although most VATS procedures are performed with the patient in the lateral decubitus position, the prone position offers several advantages for surgery on structures in the posterior mediastinum. Because gravity causes the lung to fall out of the way, lung retraction required in the lateral position is not needed when the patient is prone. Only three small incisions are needed to perform the procedure. The planes of dissection are the azygous vein, aorta, pericardium, vertebral bodies, and the trachea, allowing a thorough cancer operation with wide dissection and a complete nodal dissection to be performed. Approach to Video-Assisted Esophageal Mobilization Order of Operative Steps The order of the steps of the operation are as follows: dissect on pericardium, dissect along azygous vein and aorta, remove subcarinal nodes, clip the thoracic duct, transect the azygous vein, and dissect the esophagus at the apex of the chest. Key Points ♦ Perform esophagogastroduodenoscopy with the patient in the supine position on the gurney, and then place the patient prone on the operating table. ♦ Dissect inferiorly to superiorly in the chest. ♦ Dissect along the pericardium first, because if dissection along the azygous is done first, the esophagus falls in the way when dissecting the pericardial plane after the posterior dissection. Video-Assisted Esophageal Mobilization (Video 23) Step 1. Esophagoscopy and Positioning ♦ With the patient asleep and in the supine position on the gurney, perform esophagogastroduodenoscopy. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window) Related Related posts: Thoracoscopic Sympathectomy Right Upper Lobe Anterior Segmentectomy—Video 19 Left Upper Lobe Apical Trisegmentectomy—Video 16-1 Pneumonectomy—Video 7 Stay updated, free articles. Join our Telegram channel Join Tags: Atlas of Minimally Invasive Thoracic Surgery Jun 4, 2016 | Posted by admin in CARDIAC SURGERY | Comments Off on Video-Assisted Esophageal Mobilization—Video 23 Full access? Get Clinical Tree
Video-Assisted Esophageal Mobilization (Video 23)
