Upper mediastinal lymphadenectomy is important for esophageal squamous cell carcinoma due to its high incidence of nodal involvement. We have been focusing on the fibrous tissue 'visceral sheath' surrounding trachea, esophagus and recurrent laryngeal nerve (RLN) as an anatomical landmark for upper mediastinal lymphadenectomy in thoracoscopic esophagectomy. Surgical procedureA patient is placed in prone position under general anesthesia with both lung ventilation. First, esophagus is mobilized from descending aorta preserving thoracic duct in the lower and middle mediastinum. Azygos arch and right bronchial artery are routinely divided for maximum esophageal mobilization. In the upper mediastinum, dissection between thoracic duct and visceral sheath, which is identified as glittering membranous structure, makes esophagus, trachea and left RLN lymphatic tissue as asingle compartment, as if meso(trachea)esophagus, surrounded by visceral sheath. For RLN nodes, division of esophagotracheal vessels is a key to mobilize esophago-tracheal compartment surrounded by visceral sheath from subclavian arteries. Then, RLN nodes can be dissected by isolating RLN laterally and dividing from pretracheal fat tissue up to cervicothoracic junction. This lymphatic tissue is kept attached to esophagus and resected during cervical procedure before anastomosis. In the video presentation, upper mediastinal lymphadenectomy for T1N1 esophageal squamous cell carcinoma of 60 year old male using da Vinci Xi is presented.