Minimally Invasive Inflatable Mediastinoscope-Assisted Laparoscopic Esophagectomy for Esophageal Cancer: Case Series and Review

Background: Inflatable mediastinoscope-assisted laparoscopic esophagectomy (IMLE) is an innovative minimally invasive technique for esophageal cancer, offering reduced postoperative pain, minimal intraoperative bleeding, and accelerated recovery compared to traditional open esophagectomy. It is particularly advantageous for patients with compromised pulmonary function or comorbidities precluding transthoracic approaches. Case Presentation: We present two cases of elderly male patients with esophageal squamous cell carcinoma and dysphagia, both with a history of chronic bronchitis and moderate pulmonary impairment. Following multidisciplinary team (MDT) approval, both underwent IMLE under general anesthesia using an inflatable mediastinoscope with carbon dioxide insufflation for mediastinal dissection and lymph node clearance. One patient recovered uneventfully, while the other developed a postoperative pulmonary infection, which was successfully managed. Conclusion: IMLE provides significant benefits, including reduced morbidity, shorter recovery times, and effective oncological outcomes through comprehensive lymph node dissection. However, it demands specialized equipment and expertise, and potential complications necessitate meticulous patient selection. Further research is required to optimize this technique and broaden its clinical applicability.