The document discusses minimally invasive oesophagectomy (MIO), which refers to a group of surgical techniques for removing the esophagus through smaller incisions than traditional open surgery. It notes that while MIO is becoming more common, no randomized clinical trials have directly compared outcomes of MIO versus open surgery. The document also outlines different technical approaches to MIO, variations in techniques for the gastric conduit and anastomosis, and the steep learning curve associated with MIO adoption. It raises questions about balancing access versus radicality in resection and identifies areas for continued development, such as vagal-sparing techniques and sentinel lymph node biopsy.

1. Laparoscopic Oesophagectomy Abeezar I. Sarela Department of Upper GI & Bariatric Surgery St James’s University Hospital, Leeds, UK

4. Is Minimally Invasive Oesophagectomy Superior to Open Surgery?

7. No published randomised clinical trial of minimally invasive versus open oesphagectomy

10. Learning Curve Decker et al. Europ J Cardiothoracic Surgery. 2009;35:13-21 3.6% 46% 2.2% 4 ≥ 100 4.5% 44% 2.1% 8 ≥ 50 9.6% 60% 3.9% 29 ≤ 25 Conversion Morbidity Mortality Series Number of patients

12. Access versus Radicality Transhiatal versus Transthoracic

15. Laparoscopic Vagus-Preserving Merindino Operation with Sentinel Lymph Node Biopsy