Esophagectomy

Esophagectomy can be performed through a transhiatal approach or a traditional three-point approach. Traditional esophageal dissections have started to take advantage of robotic interventions. Traditional esophagectomy is performed in three phases: abdominal, thoracotomy, and cervical. The patient is initially in a supine position for the abdominal and cervical dissection, followed by a left lateral decubitus position for the thoracotomy.^[61] Robotically assisted surgery has replaced the traditional thoracotomy phase with robotic esophageal dissection. With the use of small trocar incisions, the patient can avoid the stress of a thoracotomy. Although the robotic surgery appears to be less painful, a thoracic epidural block for postoperative pain relief is beneficial.