Table 4 Implementation of minimally invasive oesophagectomy

Austria

No general consensus about technique, but in some specialised centres either laparoscopy or thoracoscopy is performed in the surgical treatment of oesophageal cancer. Most of these use hybrid techniques, i.e. one part minimal invasive, the other part open.

France

Hybrid minimally invasive is routine in experienced centres with laparoscopic gastric mobilisation and open thoracotomy. The aim is to decrease the rate of major postoperative pulmonary complications. Thoracoscopic oesophagectomy is reserved for high-grade dysplasia or early tumour, because it is considered that large en bloc resection for locally advanced cannot be safely done in routine

Germany

Minimal invasive surgery for the thoracic part is meanwhile the preferred in the participant’s centre (Essen), but there is no consensus in the group.

Netherlands

MIO is mainly applied for early cases. Main advantage: less pulmonary complications. After the Dutch RCT MIO is gradually also accepted for more advanced cases

Switzerland

Minimally invasive surgery is a good option for the thoracic part, especially when a cervical anastomosis is done. Others prefer a laparascopic gastric mobilisation followed by open thoracotomy and a thoracic anastomosis. There is no consensus in the group.