Laparoscopic and Thoracoscopic Transhiatal Esophagectomy with Cervical Anastomosis

In this chapter, we will outline our technique for laparoscopic and thoracoscopic transhiatal esophagectomy with cervical anastomosis. We utilize this technique routinely in patients with esophageal and Siewert’s types 1 and 2 gastroesophageal junction cancer. This technique has been shown to be safe in the setting of neoadjuvant chemoradiation since most patients in the western world present with locally advanced carcinoma and receive multimodality treatment. This technique is best reserved for those patients who have no history of previous gastric surgery such as a Nissen fundoplication. In such patients, the amount of gastric conduit available to reach the neck may be limited and an intrathoracic esophagogastric anastomosis may be preferable as described in other portions of this book.