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Exposure of cervical oesophagus
- Left cervical incision along anterior border of SCM, from sternal notch to a few cm below ear lobe (can also do it on right, not much difference)
- Deepen through subcutaneous tissue and platysma (try to preserve cervical cutaneous nerve branches)
- SCM retracted laterally
- Omohyoid divided
- Carotid sheath exposed - may need to divide ansa cervicales branches - retract laterally
- Identify inferior thyroid artery - try to preserve it
- Consider looking for left RLN
- Inferior cornu of the thyroid cartilage is a useful landmark for the proximal origin of oesophagus
- Tend to leave the proximal 1-2cm attached to larynx - difficult to separate them
- Use gentle blunt dissection to free the oesophagus down to superior mediastinum
