Blunt dissection of the esophagus as well as abdomino-thoracal esophagectomy for cancer are associated with a high operative risk. Major causes are the existing risk factors and the invasiveness of this procedure. Although blunt dissection of the esophagus can be carried out without thoracotomy, the preparation entails a high rate of postoperative morbidity. We have developed a new operative technique: endoscopic microsurgical dissection of the esophagus (EMDE). A newly developed operative mediastinoscope is used for this procedure.