fig2

Figure 2. Thoracic portion of robotic Ivor Lewis esophagectomy. Robotic ports are placed in the right chest as shown [A: (c) camera port; (a) assistant port]; dissection in the chest typically begins with division of the inferior pulmonary ligament (B) followed by circumferential dissection of the esophagus (C) to allow placement of a Penrose drain around it (D); if performing the operation for an esophageal malignancy, nodal tissue is swept up with the specimen; the airway will be visualized during the dissection (BI). The azygos vein is divided flush with the cava (E) and the esophagus is transected superior to the azygos (F); the gastric conduit is delivered into the chest (G); and the proximal esophageal margin is checked in malignant cases (H); a transoral anvil is then delivered through the esophageal staple line (I) and an end-to-end anastomotic stapler used to complete the anastomosis, performed extra-corporeally here (images not captured). BI: bronchus intermedius