Hand-assisted technique beneficial for laparoscopic transhiatal esophagectomy with en-bloc dissection of middle and lower mediastinal lymph nodes: roles of the operator’s left hand

Shiozaki, Atsushi; Fujiwara, Hitoshi; Konishi, Hirotaka; Arita, Tomohiro; Kosuga, Toshiyuki; Morimura, Ryo; Murayama, Yasutoshi; Komatsu, Shuhei; Kuriu, Yoshiaki; Ikoma, Hisashi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Okamoto, Kazuma; Otsuji, Eigo

doi:10.1007/s10388-016-0557-1

Cited by 3 publications

(14 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We made an incision (70 mm) in the upper abdomen and inserted a lap disc (regular) (Ethicon, Cincinnati, OH, USA) [11] . We introduced three 12-mm ports (right side of the umbilicus, left hypochondrium, and left flank), and one 5-mm port (left side of the umbilicus) for a flexible laparoscope [11] . The surgeon stayed at the patient's right side, and the 12-mm port in the right side of the umbilicus was chiefly used for surgery.…”

Section: Position Port Placement and Devicesmentioning

confidence: 99%

“…The assistant stayed on the left side, and two long retractors were inserted and used from ports in the left abdomen (UMIHIRA Co., Ltd., Japan). The scopist remained at the patient's groin [ Figure 1] [11] .…”

Section: Position Port Placement and Devicesmentioning

confidence: 99%

“…Carbon dioxide was introduced into the abdominal space, and pneumoperitoneal pressure was held at 10 mmHg [8][9][10][11][12] . We opened the esophageal hiatus, and carbon dioxide was introduced into the mediastinum.…”

Section: Approach To the Esophageal Hiatusmentioning

confidence: 99%

“…We began performing esophagectomy using the laparoscopic transhiatal approach for esophageal cancer in 2009 to reduce the duration of one-lung ventilation, and, to date, more than 400 patients have undergone our method during various esophageal surgical procedures [8][9][10][11] . We noted the advantages of this approach, and developed a novel technique for lower mediastinal lymph node dissection [8,10] .…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Advances and understanding pitfalls of laparoscopic transhiatal esophagectomy with en bloc mediastinal lymph node dissection

Shiozaki¹,

Fujiwara²,

Konishi³

et al. 2020

Mini-invasive Surg

Self Cite

View full text Add to dashboard Cite

We began performing mediastinal lymph node dissection using the laparoscopic transhiatal approach in 2009. Following the initiation of the single-port mediastinoscopic cervical approach in 2014, we developed a technique for transmediastinal radical esophagectomy without a thoracic approach. We herein describe our surgical procedures for en bloc mediastinal lymph node dissection by the laparoscopic transhiatal approach with a focus on pitfalls. We opened the esophageal hiatus and the working space was secured using long retractors. During division of the right crus of the diaphragm, we made efforts to avoid damaging the left hepatic vein and inferior vena cava. Dissection of the posterior plane of the pericardium was extended to the cranial side, and the bilateral inferior pulmonary veins were identified. To avoid misorientation, the posterior plane was initially extended along the long axis of the esophagus. The anterior and posterior sides of the posterior mediastinal lymph nodes were then both dissected. These lymph nodes were lifted in a sheet-like form and then cut along the borderline of the left mediastinal pleura. The right side of the mediastinal lymph nodes was then dissected. To avoid damaging the arch of the azygos vein, it was identified at the dorsal side of the right main bronchus prior to lymph node dissection. This procedure decreased the total operative time, total operative bleeding, and postoperative respiratory complications without reducing the quality of lymphadenectomy. In conclusion, the procedure described herein resulted in a good surgical view and safe en bloc mediastinal lymph node dissection. A detailed understanding of mediastinal 3D anatomy and specific pitfalls is crucial for the successful use of this approach.

show abstract

Section: Position Port Placement and Devicesmentioning

confidence: 99%

Section: Position Port Placement and Devicesmentioning

confidence: 99%

Section: Approach To the Esophageal Hiatusmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Advances and understanding pitfalls of laparoscopic transhiatal esophagectomy with en bloc mediastinal lymph node dissection

Shiozaki¹,

Fujiwara²,

Konishi³

et al. 2020

Mini-invasive Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…Para llevarlo a cabo se ha utilizado un guante de datos para poder analizar online los movimientos realizados por la mano que el cirujano introduce durante la operación en la cavidad abdominal del paciente. Se han definido diferentes movimientos teniendo en cuenta los movimientos que se realizan con la mano a analizar durante una cirugía HALS [13]. Dichos movimientos definidos no han de confundirse con movimientos realizados comúnmente durante la operación y servirán para generar comandos que, a través del sistema de control global, serán enviados al robot colaborativo para su ejecución durante la operación.…”

Section: Introductionunclassified

Detección, mediante un guante sensorizado, de movimientos seleccionados en un sistema robotizado colaborativo para HALS

Santos¹,

González²,

Fuente³

et al. 2020

XXXVIII Jornadas De Automática: Gijón, 6, 7, Y 8 De Septiembre De 2017

View full text Add to dashboard Cite

Characterization of Hand Movements using a Sensing Glove in Hand Assisted Laparoscopic Surgery

Santos

Carbonaro

Tognetti

et al. 2017

Proceedings of the 2017 4th International Conference on Biomedical and Bioinformatics Engineering

View full text Add to dashboard Cite

Hand-assisted technique beneficial for laparoscopic transhiatal esophagectomy with en-bloc dissection of middle and lower mediastinal lymph nodes: roles of the operator’s left hand

Cited by 3 publications

References 21 publications

Advances and understanding pitfalls of laparoscopic transhiatal esophagectomy with en bloc mediastinal lymph node dissection

Advances and understanding pitfalls of laparoscopic transhiatal esophagectomy with en bloc mediastinal lymph node dissection

Detección, mediante un guante sensorizado, de movimientos seleccionados en un sistema robotizado colaborativo para HALS

Characterization of Hand Movements using a Sensing Glove in Hand Assisted Laparoscopic Surgery

Contact Info

Product

Resources

About