fig4

Figure 4. Mediastinal dissection procedure under robot-assisted thoracoscopic esophagectomy in: the right upper mediastinum (A-E); the left upper mediastinum (F-J); the sub-aortic arch area (K); the sub-carinal area (L-N); the left pulmonary hilum area (O,P); and the lower mediastinum (Q,R). The robotic image is vertically and horizontally inverted by camera rotation to create a similar operative view to open thoracotomy. The left and upper sides of the monitor image are cranial and ventral, respectively. Encircled numeral corresponds to the port or arm number. The lymphatic tissue for dissection is encircled by a white dotted line. A: Aorta; AA: assistant arm; AV: azygos vein; D: diaphragm; E: esophagus; LH: left hand; LMB: left main bronchus; LRLN: left recurrent laryngeal nerve; MLN: metastatic lymph node; P: pericardium; PA: pulmonary artery; PB: pulmonary branch from vagal nerve; RH: right hand; RMB: right main bronchus; RRLN: right recurrent laryngeal nerve; S: suction; SCA: subclavian artery; T: trachea; TR: trachea retractor; VN: vagal nerve; TG: thyroid gland; LPV: left pulmonary vein; TD: thoracic duct.