Advances in minimally invasive esophageal surgery.

Advances in minimally invasive techniques have substantially expanded the role of surgery in the treatment of esophageal disease. In many cases this expansion has made more effective treatment available to a larger number of patients. Gastroesophageal reflux disease, paraesophageal hernias, and achalasia are now routinely treated laparoscopically, and laparoscopy is beginning to be used for total esophagectomy as well. The introduction of this technology has created new controversies and revitalized existing ones in the surgical treatment of esophageal disease. The indications, techniques, and outcomes of videoendoscopic approaches to the esophagus, as well as the controversies surrounding them, are discussed in this review.