HU08 Hand assisted laparoscopic oesophagectomy

Complex laparoscopic procedures such as gastric mobilization foroesophagectomy are time consuming and technically demanding, and for thesereasons this procedure is unlikely to be accepted widely unless it can besimplified and rendered technically feasible for the majority of oesophagealsurgeons. A hand assisted approach assists with gastric retraction and dissec-tion, and facilitates preservation of the gastro-epiploic arcade during mobiliza-tion of the stomach. It shortens operative time and also enables certain aspectsof the procedure to be performed under direct vision using conventional tech-niques: construction of the gastric tube, pyloromyotomy, and jejunostomy.A ‘Hand Port’ or ‘Intromit’ is placed in the right upper quadrant through a7–8 cm transverse incision. Two conventional ports (1 × 5, 1 × 12mm) and aliver retractor are also used. The gastric attachments are divided using ultra-sonic shears, and the left gastric pedicle is divided with a stapler.