Abstract
Abstract Description Thoracoscopic esophagectomy for esophageal cancer is performed via different approaches at each hospital. In order to reduce the thoracoscopic operative time, we perform mediastinal lymph node dissection via the cervical and transhiatal approach whenever possible before thoracoscopic approach. Recently totally mediastinoscopic transhiatal middle and lower lymph node dissection has been performed, and we will report the method involving constant esophageal traction and esophageal transection in the mediastinum. The mediastinal operational field obtains a clear view by transecting the esophagus on the cranial side. Futhermore, towing the thread sutured the transected esophagus to outside the abdominal cavity makes it possible to achieve good visualization of the mediastinum using the assistant's two retractors. The median total operative time was 507 minutes, and the median thoracoscopic operative time after transhiatal approach was 105 minutes. It is possible to safely perform totally mediastinoscopic middle and lower lymph node dissection with this method. Disclosure All authors have declared no conflicts of interest.
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