Thoracoscopic resection of esophageal cancer

By | March 22, 2012

Assisted thoracic surgery (thoracoscopy) and assisted thoracic surgery is minimally invasive thoracic surgery in the 20th century, the revolutionary 90's a big improvement, which uses modern imaging technology, mechanical and ultrasonic surgical instruments and electronics technology, part of the change in the traditional mainly manual chest surgery. Patients because of its respiratory and circulatory function of the small, less postoperative complications, patient pain, faster recovery, which for some older, heart and lung function or in patients not suitable for large incision thoracotomy provides another surgery choice.
Thoracoscopic resection of esophageal cancer thoracoscopic surgery in the value of diagnosis of esophageal cancer has been gradually accepted. By thoracoscopic surgery, you can clearly the site of esophageal carcinoma, degree of foreign invasion, with or without regional lymph node metastasis, thus providing an accurate TNM staging, so that clinicians can correctly select the appropriate treatment. Axillary intercostal before and after the line shoulder-length spleen and bone and 2cm at, respectively, 10mm, 5mm and 10mm long. Second, third, fourth intercostal incision in the same operation of the purpose is to avoid excessive intercostal nerve, thereby reducing the patient's postoperative pain. The incision were placed Trokar 4 out of the chest as the channel.
thoracoscopic resection of esophageal cancer from the fourth cut into 30. Thoracoscopy; second prong retractor incision into the pulmonary pressure to move the chest wall, the thoracic esophagus entirely on the monitor imaging.
thoracoscopic resection of esophageal cancer from the third cut into 5mm endoscopic forceps, lift the mediastinal pleura; from the first incision into the washing tubes with suction and electrical separation of the hook (or scalpel) to open the mediastinal pleura, from section of tumor invasion of the esophagus has not been started, to do around the separation of the esophagus. After a separation of the esophagus, esophageal filed with the vessel retractor, and with a rubber suspension to the esophagus to esophageal exposure to surrounding structures.
Thoracoscopic resection of esophageal cancer Power assisted thoracoscopic surgery for separation of the hook (or scalpel) of free space around the esophagus along the esophagus, while free, while electrocautery to stop bleeding until the azygos vein level. Nutrient artery of the esophagus after use iron clamp clamped off, or harmonic scalpel were cut off.
Thoracoscopic esophageal resection Tour bizarre vein, the use of vascular retractor to lift, double ligated with silk thread of its past, distal end, cut from the middle of two ligatures. Or EndoGIA (endoscopic suture cutting device) will be cut off after the azygos vein stapled.
thoracoscopic resection of esophageal cancer has been cut open the upper esophageal azygos vein, with fulguration (or ultrasonic knife) up separation between the esophagus and the mediastinal tissue and nourish the blood vessels, until the thoracic esophagus catchy, down the esophagus until the separation brain muscle. Separation of the trachea and esophagus inferior pulmonary vein and between the organization, should be particularly careful to avoid injury.
Check the esophageal bed without bleeding, no rupture of the contralateral pleura, the first incision into the chest tube, suture the chest the other incisions.
the patient to the supine position, the abdominal incision Rufu, free the stomach, from the cardia, down to the pylorus, the stomach to ensure there is sufficient free length to pull the neck.
thoracoscopic surgery before the left sternocleidomastoid incision, starting from the sternal notch, sternocleidomastoid front along the direction of the mastoid skin incision 8 – 10cm, cut off the platysma and superficial cervical fascia. Hyoid muscle off the shoulder of liver, thyroid vein and the inferior thyroid artery, a vein through the carotid artery behind the trachea inside the beam, free cervical esophagus, followed out of the thoracic esophagus and gastric match to prepare for. Drag the stomach at the same time, the surgeon with the other hand by gently pushing the stomach esophageal hiatus in human thoracic esophageal bed.
thoracoscopic resection of esophageal cancer cervical esophagus a row anastomosis. After the match, in its bottom, down, left and right walls were sewn on the chest with a fine silk thread at the top, on the one hand closed chest, on the other hand have a fixed anastomosis and reduce tension in the role. Neck and abdominal incisions were sutured.

Leave a Reply

Your email address will not be published. Required fields are marked *