Curative resection of gastric tube cancer by hand-assisted thoracoscopic surgery

We report a 78-year-old male who underwent successful resection of a gastric tube cancer by hand-assisted thoracoscopic surgery. The patient was initially placed in the supine position, and the abdominal portion of the gastric tube was mobilized via upper midline laparotomy. A pedicled colonic graft supplied by the left colic artery was prepared. The patient was then moved to the left decubitus position, and five ports were placed in the right chest wall. The surgeon stood in front of the patient, and inserted his left hand into the right pleural cavity through the laparotomy incision. After the whole gastric tube was successfully mobilized, the patient was returned to the supine position. The gastric tube was reconstructed with the pedicled colonic graft via the subcutaneous route. The surgical resection margins were free of cancer. The patient currently survives more than 16 months after surgery.