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Surgical procedure Surgical incision(s)/method Anesthetic concerns Transthoracic total fundoplication (Nissen) Left thoracotomy Pain management Transthoracic partial fundoplication (Belsey) One lung ventilation Collis gastroplasty Aspiration threat Thoracoscopic esophagomyotomy Left thoracoscopy (4–5 ports) Pain control Heller myotomy and modified Heller myotomy Left thoracotomy One lung air flow High aspiration threat Intraoperative esophagoscopy Transhiatal esophagectomy Midline laparotomy Aspiration threat Left cervical Incision Risk of tracheobronchial injury, bleeding, cardiac compression, and dysrhythmias Transthoracic esophagectomy (Ivor Lewis) Midline laparotomy Aspiration risk Right thoracotomy One lung air flow Three hole esophagectomy (McKewin) Right thoracotomy Protective ventilation Midline laparotomy Fluid and hemodynamic administration to optimize Left cervical incision oxygen delivery Pain management Early extubation Minimally invasive esophagectomy Right thoracoscopy (four ports) Aspiration danger Laparoscopy (5 ports) Protective ventilation Left cervical incision (variable) Procedure duration 30. 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