fig4

Figure 4. Intraoperative views of lower mediastinal lymphadenectomy in robot-assisted minimally invasive esophagectomy in the semi-prone position. (A) Parietal pleura on the dorsal side of the esophagus was incised using Maryland bipolar forceps; (B) Lymph node no. 112 was dissected from the descending aorta and the left pleura using a vessel sealer; (C) Coarse connective tissues between the lower esophagus and the pericardium were dissected using Maryland bipolar forceps. The pericardium was gently pressed and ventrally retracted by an assistant surgeon using a flexible suction retractor with a Lapaclear D cover (Hakujuji Co., Ltd); (D) Lymph node no. 111 was dissected using a vessel sealer. A: Assistant; DAo: descending aorta; Eso: esophagus; LH: left hand; RH: right hand; Ver: vertebra.