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surgical intervention video

The authors demonstrate a thoracoscopic esophagectomy in a patient with a right aortic arch.  This rare anomaly of the aorta is observed in approximately 0.01 to 0.1 percent of the general population. Three anatomical types have been described. In this patient, it is a type 2, characterized by an aberrant left subclavian artery from a diverticulum of Kommerell as a fourth branch from the aorta. The first brand is left carotid, the second is right carotid, and the third branch is the right subclavian artery. The most common approach is a left thoracotomy. In this video, we describe a right thoracoscopic approach to a MacKneown procedure for distal esophageal cancer. To the best of our knowledge, this approach has never been presented before. The video includes didactic illustrations, without any voice commentary.  Let the images speak for themselves and focus on the highlights of the video demonstration with the key steps of the operation (on the right of the video screen) guiding you throughout the procedure. The thoracic phase was followed by a laparoscopic phase for the preparation of a gastric tube, which was anastomosed to the proximal esophagus through a left cervical incision.

Right thoracoscopic McKeown esophagectomy in a patient with a right aortic arch