Transhiatal esophagectomy

Transhiatal esophagectomy

Anesthesia type	General
Airway	8-O ETT
Lines and access	Large bore PIV Arterial Line NG-tube
Monitors	Standard Arterial Line
Primary anesthetic considerations
Preoperative
Intraoperative
Postoperative	Anastamotic leak
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Provide a brief summary of this surgical procedure and its indications here.

Preoperative management

Patient evaluation

System	Considerations
Neurologic
Cardiovascular
Respiratory
Gastrointestinal
Hematologic
Renal
Endocrine
Other

Operating room setup

• 8-O ETT for periemergence bronchoscopy
• Arterial line
• Large bore peripheral IV
• NG tube to decompress stomach

Patient preparation and premedication

• EKG leads on back of shoulders to facilitate neck prep

Regional and neuraxial techniques

• Epidural for post-operative pain control

Intraoperative management

Monitoring and access

• Standard ASA Monitors
• Arterial line

Positioning

• Supine with both arms tucked

Procedure variants

• Very few series have been published comparing robotic and laparoscopic approach.

	Laparoscopic	Robotic
Unique considerations
Position	Supine	Supine; arms tucked
Surgical time	279min	267-311min
EBL	88mL	54-100mL
Postoperative disposition
Pain management		Epidural
Potential complications		Pulmonary Anastamotic leak (9-33%) Vocal cord palsy (5-30%)
Length of Stay	9.2 days	9-10 days