Minimally invasive resection for esophageal cancer

Minimally invasive esophagectomy (MIE) epitomizes the significant technologic advances in laparoscopic and thoracoscopic surgery over the past decade. MIE is technically challenging and currently is routinely performed in only a few medical centers in the world. Open esophagectomy, most frequently transhiatal, remains the standard approach in most medical centers but continues to be associated with significant morbidity and mortality [1,2]. Due to concerns over the morbidity of standard esophagectomy, non-surgical approaches to esophageal cancer or high-grade dysplasia are being reported, including photodynamic therapy, definitive chemoradiation, mucosectomy, and others, which should encourage surgeons to consider alternative approaches. The goals of MIE should be to decrease the morbidity of esophagectomy, decrease postoperative pain, and reduce costs by decreasing intensive care unit and hospital days. This chapter summarizes the work in the authors' center and by other investigators who perform MIE.