SILS (single access) transhiatal esophagectomy for cancer
Epublication WebSurg.com, Sep 2014;14(09). URL: http://websurg.com/doi/vd01en4154
An 82-year-old man was referred to our department for a 3cm long esophageal cancer. He was smoking 40 cigarettes a day and drinking 1.5L of wine a day. He had a BMI of 21 and he was ASA 2. A CT-scan showed a 3cm tumor not entering the muscle layer and no nodes were found in the mediastinum. No liver metastases were visible on CT-scan and ultrasonography (US). During GI endoscopy, a biopsy showed an esophageal adenocarcinoma. Ejection fraction (EF) during cardiac ultrasound was 55%. After 15 days of gym workouts in our department (15 minutes of exercise bike in the morning and 20 minutes in the afternoon, and inflating 30 balloons in the morning, 30 at lunchtime and 30 before nighttime), the patient was operated on. A laparoscopic transhiatal single port esophagectomy was performed according to Orringer’s technique. Procedure time was 195 minutes. Estimated blood loss was nihil. Time in ICU was 24 hours and hospital stay was 7 days. This was our 11th case using this technique.