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Ann Thorac Surg 2006;81:2318-2320
© 2006 The Society of Thoracic Surgeons

How to do it

Preoperative Laparoscopic Ligation of the Left Gastric Vessels in Preparation for Esophagectomy

Ninh T. Nguyen, MD * , Mario Longoria, MD, Allen Sabio, BS, Sara Chalifoux, BS, John Lee, MD, Ken Chang, MD, Samuel E. Wilson, MD

Department of Surgery and Medicine, University of California Irvine Medical Center, Orange, California

Accepted for publication May 10, 2005.

* Address correspondence to Dr Nguyen, 101 The City Dr, Bldg 55, Rm 106, Orange, CA 92868 (Email: ninhn{at}uci.edu).

Anastomotic leak is a major cause for morbidity after esophagectomy. The cause is believed to be ischemia of the gastric conduit. Preoperative embolization of the left gastric vessels in preparation for esophagectomy has been shown to improve collateral blood flow of the gastric conduit and may reduce the frequency of anastomotic dehiscence after esophagectomy. This report describes the technique of laparoscopic division of the left gastric vessels in 9 patients who underwent pre-esophagectomy staging laparoscopy. Our initial experience demonstrates that laparoscopic ligation of the left gastric artery is a safe alternative to embolization and can be performed in conjunction with staging laparoscopy for patients with esophageal cancer.




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