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Surgical Case Reports
Fig. 4 | Surgical Case Reports

Fig. 4

From: Laparoscopic and left thoracoscopic Ivor-Lewis esophagectomy for Siewert type II esophagogastric junction cancer with right aortic arch: a case report

Fig. 4

Radiological and surgical images showing left thoracoscopic ILE with an RAA. Schema for the port setting (a). Overview of the laparoscopic lower mediastinal lymphadenectomy performed (b). A trans-hiatal approach was performed without being impeded by the RAA. Radiological images obtained by three-dimensional CT reconstruction using Synapse Vincent software (Fujifilm, Tokyo, Japan) (c) were compared with the surgical field (d) under a left thoracoscopic approach. Yellow arrows indicate the esophagus. Both images show that the esophagus was located to the left of the descending aorta and would be visible with left thoracotomy. An intrathoracic esophageal–gastric anastomosis was constructed via a left transthoracic approach (e)

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