title: Endoscopic evaluation of gastric conduit perfusion in minimally invasive Ivor Lewis esophagectomy.
abstract: BACKGROUND
  Laser-assisted indocyanine green (ICG) fluorescent dye angiography has been used in esophageal reconstructive surgery where it has been shown to significantly decrease the anastomotic leak rate. Recent advances in technology have made this possible in minimally invasive esophagectomy.
  
  
  METHODS
  We present a 69-year-old male with a cuT2N0M0 adenocarcinoma of the esophagus at the gastroesophageal junction who presented to our clinic after chemoradiation and underwent a minimally invasive Ivor Lewis esophagectomy. The perfusion of the gastric conduit was assessed intraoperatively using endoscopic ICG fluorescent imaging system. The anastomosis was created at the well-perfused site identified on the fluorescent imaging. The patient tolerated the procedure well, had an uneventful recovery going home on postoperative day 6 and tolerating a regular diet 2 weeks after the surgery.
  
  
  CONCLUSIONS
  Combination of minimally invasive surgery and endoscopic evaluation of perfusion of gastric conduit provide improved outcomes for surgical treatment for patients with esophageal cancer.
  
  
  CONCLUSIONS
  The gastric conduit during minimally invasive Ivor Lewis esophagectomy can be evaluated using endoscopic ICG fluorescent imaging.
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, Houston, TX, USA.
authors.forename: Vid
authors.initials: V
authors.lastname: Fikfak
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, Houston, TX, USA; Department of Surgery, Weill Cornell Medical College, Houston Methodist Hospital, Houston, TX, USA.
authors.forename: Puja
authors.initials: P
authors.lastname: Gaur
authors.affiliation: Division of Thoracic Surgery, Department of Surgery, Houston Methodist Hospital, Houston, TX, USA; Department of Surgery, Weill Cornell Medical College, Houston Methodist Hospital, Houston, TX, USA. Electronic address: mpkim@houstonmethodist.org.
authors.forename: Min P
authors.initials: MP
authors.lastname: Kim
keywords: Indocyanine green; Laser angiography; Minimally invasive esophagectomy