With the introduction of laparoscopy in surgical oncology, its role in management of esophageal cancer is increasing. Minimally invasive esophagectomies are technically challenging and are currently performed in only a few medical centers in the world. This video demonstrates the technique of transhiatal esophagectomy for lower third lesions of esophagus.

Patient is placed in semilithotomy with reverse Trendelenberg position and pneumoperitoneum created by Veress needle technique. After completing general survey, leftlobe of liver is retracted. The lesser omentum is incised, the left gastric artery and vein dissected, ligated with silk and divided. All lymphofatty tissue around the branches of the celiac artery are completely removed. The esophagus is separated from the right crus and anteriorly it's freed by dividing the phrenoesophageal membrane. Subsequent dissection is in mediastinum. At this stage, we change our 30 degree to 0 degree scope. Simultaneously, a thorough lymphnodal dissection is performed in the posterior. After division of the esophagus at the neck , the specimen is pulled into the peritoneal cavity and exteriorized through a minilaparotomy. The stomach tube is created and oulled inside the abdomen and thoracic cavity and anastamosed to the neck as shown in the video.