How to Do ItPatient Position for a Synchronous Cervicothoracoabdominal Two-Team Esophagectomy
Section snippets
Technique
The main feature of this technique is the possibility, by rotating the table on each side, of obtaining a horizontal supine patient position or a right chest up patient position as for a normal laparotomic or thoracotomic procedure.
The patient is positioned on the bed with a 30-degree tilt of the body on the left side (Fig. 1). The legs are positioned as for a right thoracotomic procedure. The right hand and forearm are gloved with a soft padding and the hand is tucked under the right loin (
Comment
Our variation of the Nanson’s position permits the operation to be carried out as if each step of the procedure were performed singularly and yet without redraping or repositioning of the patient. It maintains the advantage of shortening the operating time by means of a synchronous combined two-team operation. As opposed to the simultaneous thoracoabdominal approach described by Nanson, we suggest one team working on the neck and one on the abdomen, followed by simultaneous closure of the three
Acknowledgements
We thank Nadia Nuvoli for the excellent illustrations.
References (7)
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Aust N Z J Surg
(1975)Synchronous combined abdominothoracocervical esophagectomy
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Two team synchronous esophagectomy
Surg Gynecol Obstet
(1990)