On the thoracic half of my cardiothoracic rotation, I essentially was in solely esophagectomies all week (for better or for worse). These tended to range from 8-10 hours and I was remorseful that I did not get to see any lung lobe resections or lung surgeries. Being in three esophagectomies, however, I started to get a sense of the pimp questions that one specific attending like to ask. Here are some of the questions that you may get asked during an esophagectomy, without answers included so that you can learn something new and research them yourself!
Abdomen – Where is the Ligament of Treitz? What can you visualize in the lesser sac? What is the vascular supply to the gastro-esophageal conduit we are creating/which artery are we trying to preserve? What is the vascular supply to the stomach? (Hint: think celiac trunk!)
Innervation – What nerve innervates the diaphragm? What does the vagus nerve do? What is its contribution to the sphincter of Oddi? How does it impact parietal cell secretion?
Thoracic cavity – What muscle layers are we going through to perform a thoracotomy? Where is the thoracic duct? Where is the azygos vein?
General – What are the different types of esophagectomies you can do (in relation to incision)?
And as for any procedure, you may get asked questions about the patient, so know their background and why they are getting the surgery done. Also, know the indications for the procedure, and big anatomical landmarks.
