Usefulness of a single trocar for intrathoracic anastomosis during open thoracic surgery for esophageal cancer.
When patients with esophageal cancer undergo intrathoracic anastomosis after esophagectomy in our institution, we resect the lesser curvature in the thorax using a surgical instrument after circular-stapled esophagogastric anastomosis. We then place the trocar in the seventh intercostal space on the midaxillary line, except in fifth intercostal anterolateral thoracotomy. A linear stapler applied through the thoracotomy sometimes blocks the operator's view, and so it is not so easy to operate with a rather big head in the thorax. We operate a linear cutter for laparoscopic surgery through the trocar. With this method, the instrument is used in good position in respect to the operator's view, and access to the gastric tube is easy. Moreover, we can adjust the resectional angle with this instrument by using the bending mechanism in its shaft. Furthermore, we can reuse the trocar site for the chest tube.
Tonouchi
Hitoshi
H
Department of Innovative Surgery, Mie University School of Medicine, Edobashi 2-174, Tsu-City, Mie 514-8507, Japan.
Mohri
Yasuhiko
Y
Tanaka
Kouji
K
Ohmori
Yukinari
Y
Kobayash
Minako
M
Yokoe
Takeshi
T
Kusunoki
Masato
M
D000714:Anastomosis, Surgical / Q000379:methods; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D004947:Esophagus / Q000601:surgery; D006801:Humans; D013270:Stomach / Q000601:surgery; D013525:Surgical Instruments; D013537:Sutures