The surgical anatomy of a (robot-assisted) minimally invasive transcervical esophagectomy
© The Author(s) 2022. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com..
BACKGROUND: Transcervical esophagectomy allows for esophagectomy through transcervical access and bypasses the thoracic cavity, thereby eliminating single lung ventilation. A challenging surgical approach demands thorough understanding of the encountered anatomy. This study aims to provide a comprehensive overview of surgical anatomy encountered during the (robot-assisted) minimally invasive transcervical esophagectomy (RACE and MICE).
METHODS: To assess the surgical anatomy of the lower neck and mediastinum, MR images were made of a body donor after, which it was sliced at 24-μm intervals with a cryomacrotome. Images were made every 3 slices resulting in 3.200 images of which a digital 3D multiplanar reconstruction was made. For macroscopic verification, microscopic slices were made and stained every 5 mm (Mallory-Cason). Schematic drawings were made of the 3D reconstruction to demonstrate the course of essential anatomical structures in the operation field and identify anatomical landmarks.
RESULTS: Surgical anatomy 'boxes' of three levels (superior thoracic aperture, upper mediastinum, subcarinal) were created. Four landmarks were identified: (i) the course of the thoracic duct in the mediastinum; (ii) the course of the left recurrent laryngeal nerve; (iii) the crossing of the azygos vein right and dorsal of the esophagus; and (iv) the position of the aortic arch, the pulmonary arteries, and veins.
CONCLUSIONS: The presented 3D reconstruction of unmanipulated human anatomy and schematic 3D 'boxes' provide a comprehensive overview of the surgical anatomy during the RACE or MICE. Our findings provide a useful tool to aid surgeons in learning the complex anatomy of the mediastinum and the exploration of new surgical approaches such as the RACE or MICE.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus - 36(2023), 4 vom: 30. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Filz von Reiterdank, I C L J [VerfasserIn] |
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| Links: |
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| Themen: |
Esophagus |
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| Anmerkungen: |
Date Completed 31.03.2023 Date Revised 31.03.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1093/dote/doac072 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM347372325 |
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| 100 | 1 | |a Filz von Reiterdank, I C L J |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The surgical anatomy of a (robot-assisted) minimally invasive transcervical esophagectomy |
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| 520 | |a © The Author(s) 2022. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissionsoup.com. | ||
| 520 | |a BACKGROUND: Transcervical esophagectomy allows for esophagectomy through transcervical access and bypasses the thoracic cavity, thereby eliminating single lung ventilation. A challenging surgical approach demands thorough understanding of the encountered anatomy. This study aims to provide a comprehensive overview of surgical anatomy encountered during the (robot-assisted) minimally invasive transcervical esophagectomy (RACE and MICE) | ||
| 520 | |a METHODS: To assess the surgical anatomy of the lower neck and mediastinum, MR images were made of a body donor after, which it was sliced at 24-μm intervals with a cryomacrotome. Images were made every 3 slices resulting in 3.200 images of which a digital 3D multiplanar reconstruction was made. For macroscopic verification, microscopic slices were made and stained every 5 mm (Mallory-Cason). Schematic drawings were made of the 3D reconstruction to demonstrate the course of essential anatomical structures in the operation field and identify anatomical landmarks | ||
| 520 | |a RESULTS: Surgical anatomy 'boxes' of three levels (superior thoracic aperture, upper mediastinum, subcarinal) were created. Four landmarks were identified: (i) the course of the thoracic duct in the mediastinum; (ii) the course of the left recurrent laryngeal nerve; (iii) the crossing of the azygos vein right and dorsal of the esophagus; and (iv) the position of the aortic arch, the pulmonary arteries, and veins | ||
| 520 | |a CONCLUSIONS: The presented 3D reconstruction of unmanipulated human anatomy and schematic 3D 'boxes' provide a comprehensive overview of the surgical anatomy during the RACE or MICE. Our findings provide a useful tool to aid surgeons in learning the complex anatomy of the mediastinum and the exploration of new surgical approaches such as the RACE or MICE | ||
| 650 | 4 | |a Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a MICE | |
| 650 | 4 | |a RACE | |
| 650 | 4 | |a esophagus | |
| 650 | 4 | |a mediastinum | |
| 650 | 4 | |a minimally invasive | |
| 650 | 4 | |a oncology | |
| 650 | 4 | |a robot-assisted | |
| 700 | 1 | |a Defize, I L |e verfasserin |4 aut | |
| 700 | 1 | |a de Groot, E M |e verfasserin |4 aut | |
| 700 | 1 | |a Wedel, T |e verfasserin |4 aut | |
| 700 | 1 | |a Grimminger, P P |e verfasserin |4 aut | |
| 700 | 1 | |a Egberts, J H |e verfasserin |4 aut | |
| 700 | 1 | |a Stein, H |e verfasserin |4 aut | |
| 700 | 1 | |a Ruurda, J P |e verfasserin |4 aut | |
| 700 | 1 | |a van Hillegersberg, R |e verfasserin |4 aut | |
| 700 | 1 | |a Bleys, R L A W |e verfasserin |4 aut | |
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