Lymphadenectomy Along Bilateral Recurrent Laryngeal Nerves Under Single-Incision Mediastinoscopy

Abstract

This report proposes an approach for lymphadenectomy along bilateral recurrent laryngeal nerves (RLNs) under mediastinoscopy through a single left-neck incision. After pneumomediastinum is established, esophagectomy is begun over the aortic arch to the level of the lower edge of the left main bronchus, and lymphadenectomy along the left RLN is also accomplished. At the level of the lower edge of the right subclavian artery, between the trachea and the esophagus, the instruments can gain access to the right RLN. The lymphadenectomy may be performed up to 2 cm above the upper edge of the right subclavian artery.