Total Esophagectomy

The benefits of using laparoscopic technique for total esophagectomy have been already reported [10, 11]. The laparoscopic transhiatal dissection of the esopha-geal body near the pulmonary vein, the aorta, and the parietal pleura is very challenging. Our first robotic-assisted transhiatal esophagectomy was reported in 2003 [12]. For this procedure, the thoracic portion of the operations (via the abdomen) is undertaken with the robotic system, and one assistant port. The cervical anastomosis is carried out with an open cervical incision in all cases. The articulated instruments using the robotic system allow precise blunt and sharp dissection of the intrathoracic esophageal attachments. The benefits of robotics are maximized in this surgery in that the reticulating writs allow the surgeon to navigate such a narrow space of dissection. Because of this reticulation, the shaft of the instruments is out of the surgeon's view, keeping the field clear. The three-dimensional image and the chance of magnification of the operative field view provide extreme detail and clarity. When scarring is present, making tissue less yielding to blunt dissec

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