Two-Incision Esophagectomy Procedure for Esophageal Cancer

Also known as the Ivor-Lewis procedure, the two-incision esophagectomy is a surgical method commonly used in the treatment of esophageal cancer. This approach involves two distinct surgical phases, beginning with an abdominal incision that allows the surgeon to carefully free the stomach and remove any lymph nodes affected by cancerous cells in the abdominal cavity.

Step-by-Step Surgical Process

Once the abdominal portion of the surgery is complete, the incision is closed and the patient is repositioned from a supine to a left lateral decubitus position. This adjustment enables the surgical team to make a second incision on the right side of the chest, through which the diseased portion of the esophagus is removed and surrounding lymph nodes are cleared.

Reconstruction and Final Stages

Following the removal of the tumor, the surgeon then brings the stomach up through the diaphragmatic hiatus into the chest cavity. The next step involves creating a connection—known as an anastomosis—between the remaining healthy esophagus and the relocated stomach. Once this connection is securely in place, the chest incision is closed, marking the completion of the two-incision esophagectomy procedure.

This surgical technique is favored for its thorough approach to cancer removal while allowing for effective reconstruction, offering patients a better chance at long-term recovery and improved quality of life.