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Usefulness of a single trocar for intrathoracic anastomosis during open thoracic surgery for esophageal cancer

Authors
  • Tonouchi, Hitoshi
  • Mohri, Yasuhiko
  • Tanaka, Kouji
  • Ohmori, Yukinari
  • Kobayash, Minako
  • Yokoe, Takeshi
  • Kusunoki, Masato
Type
Published Article
Journal
The American Journal of Surgery
Publisher
Elsevier
Publication Date
Jan 01, 2005
Volume
189
Issue
2
Pages
240–242
Identifiers
DOI: 10.1016/j.amjsurg.2004.09.012
Source
Elsevier
Keywords
License
Unknown

Abstract

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.

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