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Minimally Invasive Ivor Lewis Oesophagectomy (MIE)

Modern oncological surgery for oesophageal cancer using laparoscopic and thoracoscopic approaches.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Genel Cerrahi department. Book Appointment →

What is Minimally Invasive Ivor Lewis Oesophagectomy (MIE)?

Minimally invasive Ivor Lewis oesophagectomy (MIE) is an advanced oncological operation for distal oesophageal and gastro-oesophageal junction tumours that combines laparoscopic gastric mobilisation with right-sided thoracoscopic oesophageal resection and intrathoracic anastomosis.

Compared with open Ivor Lewis, MIE is associated with reduced postoperative pain, shorter hospital stay, fewer pulmonary complications and faster return to oncological therapy. It can be performed after neoadjuvant chemoradiotherapy.

There is a steep learning curve for centres adopting the technique. Five-year survival and oncological adequacy are comparable to open surgery; perioperative mortality in experienced centres is around 2-4%.

Symptoms

Histologically confirmed oesophageal adenocarcinoma
Gastro-oesophageal junction cancer (Siewert I-II)
Lower-third oesophageal carcinoma
Resectability after neoadjuvant therapy
Good performance status
Adequate cardiopulmonary reserve
Absence of distant metastasis
Eligibility for R0 resection

Risk Factors

Anastomotic leak (5-15%)
Pulmonary complications
Chylothorax
Recurrent laryngeal nerve injury
Gastric conduit ischaemia
Anastomotic stricture
Malnutrition
Risk of conversion

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Respiratory distress and fever
  • Neck swelling and surgical emphysema
  • Chest pain
  • Worsening dysphagia
  • Enteric or chylous fluid in drains
  • Hoarseness

Treatment Methods

01
Neoadjuvant chemoradiotherapy (CROSS protocol)
02
Preoperative staging (PET-CT, endoscopic ultrasound)
03
Laparoscopic gastric mobilisation and gastric conduit creation
04
Right thoracoscopic oesophageal dissection
05
Intrathoracic end-to-side or side-to-side anastomosis
06
Mediastinal and celiac lymphadenectomy
07
Pyloric drainage (optional)
08
Early enteral nutrition and physiotherapy

Which Department to Visit?

You can visit our Genel Cerrahi department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.