ABSTRACT
Procedure Step 1. The patient is placed in the supine position. Typically, a diagnostic lapa
roscopy is undertaken to rule out sub-radiographic metastases to the peritoneum or hepatic surface. If the laparoscopy is negative, open abdominal exploration is under taken. Either a midline or bilateral subcostal incision can be used. A self-retaining retractor should be inserted to provide good exposure of the esophageal hiatus and celiac lymph nodes.
