ABSTRACT
Minimally invasive esophagectomy (MIE) has become an established option in the approach to esophageal resection and reconstruction for cancer. Technical and oncological outcomes are similar to those of open surgery, with evidence for improved respiratory outcomes with the MIE approach. The laparoscopic gastric mobilization can be performed as the first phase of an Ivor Lewis approach with the chest performed open or thoracoscopically. It can be performed as the second phase of a three-field resection when the thoracoscopic component is the first phase and a cervical anastomosis is performed. This chapter describes laparoscopic gastric mobilization as the first phase of an Ivor Lewis resection, and then, as part of a three-phase thoracoscopic esophageal mobilization with a gastric conduit taken to the neck. It then discusses the prone thoracoscopic approach used for a three-phase procedure and finally the thoracoscopic approach for an Ivor Lewis procedure with an intrathoracic anastomosis.
