Hand-assisted thoracoscopic esophagectomy

Esophagectomy for esophageal cancer is a challenging procedure for elderly patients. We applied hand-assisted laparoscopic technique, which has been recently reported in the literature, to esophagectomy. This is the first report of Hand-assisted thoracoscopic esophagectomy. The operators left hand was inserted into the right thoracic cavity via the retro sternal space through a mid-upper abdominal incision, without opening the abdominal cavity. Almost all procedure can be done, as if open thoracotomy. We performed esophagectomy and mediastinal lymphnode dissection by this technique, and reconstruction was performed by stomach tube through retrosternal route.