Creating a Straight Conduit: The Pleural Closure Technique in Ivor Lewis Esophagectomy

Ivor Lewis esophagectomy, a surgical procedure to treat esophageal cancer, requires gastric conduit creation with an intrathoracic anastomosis. Frequently encountered conduit complications include conduit redundancy, herniation, and dreaded complications of necrosis and anastomotic leak. We present the case of a 71-year-old male with esophageal cancer who underwent robot-assisted laparoscopic and thoracoscopic Ivor Lewis esophagectomy with total portal robotic linear stapled anastomosis with the omentum at the anastomosis and pleural closure. On postoperative imaging, the patient had a straight gastric conduit without redundancy or anastomotic leak. He had excellent long-term clinical outcomes without significant dysphagia and reflux. Pleural closure during robotic Ivor Lewis esophagectomy may aid in achieving excellent functional outcomes.