Combined laparoscopic and thoracoscopic Ivor Lewis esophagectomy using the transorally inserted anvil—the experience of Fujian Medical University Union Hospital

Surgical approaches for treating esophageal carcinoma include the transhiatal esophagectomy (THE) and the transthoracic esophagectomy (TTE) with the anastomosis in the thorax or the neck. Compared with THE, TTE can resect more extensive intrathoracic esophageal tumors. Meanwhile, the range of the resected mediastinal lymph nodes with TTE is wider than THE. Performing an intrathoracic esophagogastric anastomosis using MIE techniques can be technically challenging and time-consuming (1,2). Combined laparoscopic with thoracoscopic Ivor-Lewis esophagectomy needs video-assisted mini-thoracotomy and the use of Endo-GIA stapler over and over. Due to the use of OrVil system, the operation of the intrathoracic esophagus anastomosis has become easy, and the operation time has reduced.