Use of minimally invasive oesophagectomy for cancer of the oesophagus.

Minimally invasive surgery has had a great effect on all branches of surgery, although its use for oesophageal cancer is controversial because of the technical complexity of the techniques involved and its uncertain benefits. We review the minimally invasive techniques that have been used for oesophagectomy. The methods are certainly feasible and can be done safely in experienced centres, but postoperative morbidity and mortality rates are not substantially reduced by the procedure. There are also concerns regarding the adequacy of tumour clearance. Further evaluation of the role of minimally invasive techniques in oesophageal cancer would require larger scale studies, preferably randomised controlled trials, in experienced centres. However, given that survival rates have not changed, proving that minimally invasive techniques are more effective than conventional methods of oesophagectomy, will be a difficult task.