Laparoscopic Transhiatal Esophagectomy

Abstract

Transhiatal esophagectomy (THE) was first successfully performed by Turner in 1933.¹ As anesthetic methods improved, the transthoracic approach to esophageal resection became the preferred modality. Nevertheless, the morbidity of the transthoracic approach eventually led to a reintroduction of the transhiatal approach by Orringer in 1978.² Institution- specific and multiinstitution studies since that time have failed to provide a consistent picture of the preferred approach to esophagectomy. While some studies suggest that transthoracic esophagectomy (TTE) provides better outcomes, others indicate that THE is associated with lower morbidity and equivalent respectability rates.^3–6 Thus, esophageal surgeons continue to be challenged to improve the surgical treatment of esophageal disorders, even in the 1990s.