World Journal of Laparoscopic Surgery

Register      Login

VOLUME 4 , ISSUE 1 ( January-April, 2011 ) > List of Articles


Minimally Invasive Esophagectomy (MIE): Techniques and Outcomes

Sajesh Gopinath

Citation Information : Gopinath S. Minimally Invasive Esophagectomy (MIE): Techniques and Outcomes. World J Lap Surg 2011; 4 (1):53-58.

DOI: 10.5005/jp-journals-10007-1116

Published Online: 01-08-2013

Copyright Statement:  Copyright © 2011; The Author(s).



Esophageal cancer is one of the major public health problems worldwide. Different methods of minimally invasive esophagectomy (MIE) have been described, and they represent a safe alternative for the surgical management of esophageal cancer in selected centres with high volume and expertise in them. The procedural goal is to decrease the high overall morbidity of a traditional open esophageal resection.


This article reviews the most recent and largest series evaluation of MIE techniques.


A literature search performed using search engines Google, HighWire press, SpringerLink, and Yahoo. Selected papers are screened for other related reports.


Though MIE requires greater expertise and a long learning curve, once technique has been mastered it greatly reduces the postoperative morbidity and mortality to a significant extent. There was not much difference in average operating time compared to open surgery but bleeding was less in MIE. Mean hospital stay was similar to open surgery. There was no significant difference in number and location of lymph nodes harvested.


The current review shows that MIE with its decreased blood loss, minimal cardiopulmonary complications and decreased morbidity and oncological adequacy, represents a safe and effective alternative for the treatment of esophageal carcinoma.

PDF Share
  1. Patterns of cancer incidence, mortality, and prevalence across five continents: Defining priorities to reduce cancer disparities in different geographic regions of the world. J Clin Oncol 2006;24:2137-50.
  2. Cancer statistics, 2007. CA Cancer J Clin 2007;57:43-66.
  3. Chemotherapy followed by surgery compared with surgery alone for localized esophageal cancer. N Engl J Med 1998;339:1979-84.
  4. Chemoradiotherapy followed by surgery compared with surgery alone in squamous cell cancer of the esophagus. N Engl J Med 1997;337:161-67.
  5. Endoscopic oesophagectomy through a right thoracoscopic approach. JR Coll Surg Edinb 1992;37:7-11.
  6. Laparoscopic transhiatal esophagectomy with esophagogastroplasty. Surg Laparosc Endosc 1995;5:1-5.
  7. Laparoscopic total esophagectomy. Arch Surg 1997132943-47. discussion 947-49.
  8. Postoperative mortality following esophagectomy and problems in reporting its rate. Br J Surg 2004;91:943-47.
  9. Minimal invasive esophagectomy: Outcomes in 222 patients. Ann Surg 2003;238:486-95.
  10. Minimally invasive resection and mechanical cervical esophagogastric anastomotic techniques in the management of esophageal cancer. J Gastroint Surg 2004;8:927-29.
  11. The role of surgery in the management of oesophageal cancer. Lancet Oncol 2003;4:481-88.
  12. Eliminating the cervical esophagogastric anastomotic leak with a side-to-side stapled anastomosis. J Thorac Cardiovasc Surg 2000;119:277-88.
  13. Reflections on three field lymphadenectomy in carcinoma of the esophagus and gastroesophageal junction. Hepatogastroenterology 1999;46:717-25.
  14. En bloc and standard esophagectomies by thoracoscopy. Ann Thorac Surg 1993;56:675-79.
  15. Thoracoscopic and laparoscopic esophagectomy: Initial experience and outcomes. Surg Endosc 2005;19:1597-1601.
  16. Hand-assisted laparoscopic and thoracoscopic surgery (HALTS) in radical esophagectomy with three-field lymphadenectomy for thoracic esophageal cancer. Eur J Surg Oncol 2005;31:1166-74.
  17. Minimally invasive esophagectomy: Thoracoscopic mobilization of the esophagus and mediastinal lymphadenectomy in prone position—experience of 130 patients. J Am Coll Surg 2006;203:7-16.
  18. Endoscopic microsurgical dissection of the esophagus (EMDE). Int Surg 1997;82:109-12.
  19. Esophagectomy via laparoscopy and transmediastinal endodissection. J Laparoendosc Adv Surg Tech A 2004;14:13-16.
  20. Robotically assisted laparoscopic transhiatal esophagectomy. Surg Endosc 2008;22:188-95.
  21. Robotic-assisted minimally invasive transhiatal esophagectomy. Am Surg 2003;69:624-26.
  22. Minimally invasive treatment of esophageal cancer: Laparoscopic staging to robotic esophagectomy. Cancer J 2005;11:10-17.
  23. J Thoracoscopic and laparoscopic oesophagectomy improves the quality of extended lymphadenectomy Surg Endosc 2006;20:1308-09.
  24. John G Perioperative outcomes of laparoscopic transhiatal inversion esophagectomy compare favorably with those of combined thoracoscopic-laparoscopic esophagectomy Surg Endosc 2009;23:2147-54.
  25. Totally laparoscopic transhiatal esophago-gastrectomy without thoracic or cervical access. Surg Endosc 2004;18:629-32.
  26. Laparoscopic transhiatal esophagectomy: Outcomes. Surg Endosc 2007;21:1284-87.
  27. Botha Perioperative outcomes after transition from conventional to minimally invasive Ivor-Lewis esophagectomyin a specialized center Surg Endosc 2010;24:865-69.
  28. Totally endoscopic Ivor Lewis esophagectomy. Surg Endosc 1999;13:293-97.
  29. H Open transthoracic or transhiatal esophagectomy versus minimally invasive esophagectomy in terms of morbidity, mortality and survival. Surg Endosc 2006;20:1681-86.
  30. JH The first series of completely robotic esophagectomies with three-field lymphadenectomy: Initial experience. Surg Endosc 2007;21:2285-92.
  31. Thoracolaparoscopy in the lateral position for esophageal cancer: The experience of a single institution with 112 consecutive patients. Surg Endosc 14 January 2010.
  32. Minimally invasive transhiatal esophagectomy: Lessons learned. Surg Endosc 2007;21:1190-93.
  33. M Mediastinoscope-assisted transhiatal esophagectomy for esophageal cancer Surg Endosc 2004;18:383-89.
  34. DI Thoracoscopic and laparoscopic esophagectomy Surg Endosc 2005;19:1597-601.
  35. D Experience with minimally invasive esophagectomy. Surg Endosc 2006;20:298-301.
  36. Rodehorst Minimally invasive transhiatal and transthoracic esophagectomy. Surg Endosc 2007;21:1695-700.
  37. Open versus minimally invasive esophagectomy: A single center case controlled study. Surg Endosc 2 April 2010.
  38. Minimally Invasive Esophagectomy Gastrointest. Surg (2010) 14(Suppl 1):S108-14.
  39. Shahjehan Comparative Experience of Open and Minimally Invasive Esophagogastric Resection World J Surg 2009;33:1868-75.
  40. Minimally Invasive versus Open Esophagectomy for Patients with Oesophageal cancer. Ann Thorac Surg 2009;87:911-19.
  41. Comparison of minimally invasive esophagectomy with transthoracic and transhiatal esophagectomy. Arch Surg 2000;135:920-25.
  42. Comparison of the outcomes between open and minimally invasive esophagectomy. Ann Surg 2007;245:232-40.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.