Open oesophagectomy with thoracotomy is associated with a high respiratory complication rate. Minimal access mobilisation of the oesophagus reduces the chest wall pain and the respiratory compromise associated with the thoracic component of the operation.

The patient is placed prone with a 30 degree roll away. In this position, the lung falls forward away from the oesophagus allowing clear access.

Once the thoracoscopic mobilisation is complete, the patient is placed supine. The gastric mobilisation can be completed open, laparoscopically or by hand assisted laparoscopy.

the stomach is drawn through the posterior mediastinum and a hand-sutured anastomosis is completed through a small left cervical incision.