OESOPHAGECTOMY (TRANSHIATAL)
Indication: Carcinoma of the lower or mid-oesophagus in patients where a thoracotomy carries high risk (poor pulmonary function, prior thoracic procedures). Avoids thoracotomy; relies on blunt dissection of the mid-oesophagus.
Patient Position: Supine. Head of table elevated.
Anaesthesia: General.
Incisions: Upper midline laparotomy and left cervical incision.
Procedure:
1. Abdominal phase: Stomach mobilised as per Ivor Lewis technique. Conduit fashioned. Pyloromyotomy performed.