Transthoracic Subtotal Esophagectomy (Lewis Type Procedure)

Surgery for cancer of the esophagus is one of the most complex, requiring the ability to operate both in the abdominal and thoracic cavities. In surgery for cancer the knowledge of anatomy, ability to work in anatomical layers is an important prerequisite to perform radical surgery. The removal of the tumor in a single bloc with fatty tissue containing the regional lymph nodes is the main task of this intervention. In this film, I tried to focus on the technical aspects of the operation and to demonstrate the manual surgical principles. The film shows the methodology of subtotal transthoracic esophagectomy with lymphnode dissection (2F) in the abdominal and thoracic cavities, shows the main principles of work with anatomical tissues. It was performed for T3N0M0 esophageal cancer (squamous cell carcinoma). Video by Ilya Gotsadze (M.D., Ph.D.)