The mediastinal pleura is divided and the entire thoracic esophagus is exposed in a way that the azygos vein is preserved. Then the inferior pulmonary ligament is divided to the level of the inferior pulmonary vein. A silicone drain is placed around the distal esophagus to facilitate traction and exposure, and ultrasonic shears are used for dissection of the peri-esophageal tissues, which should remain attached en bloc to the specimen. The thoracic duct should be sutured with non-resorbable material in order to reduce the risk of chylothorax, and direct vessels from the aorta should be clipped to avoid rebleeding.
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For centuries, ever since the legendary Ponce de Leon went searching for the elusive Fountain of Youth, people have been looking for ways to slow down the aging process. Medical science has made great strides in keeping people alive longer by preventing and curing disease, and helping people to live healthier lives. Average life expectancy keeps increasing, and most of us can look forward to the chance to live much longer lives than our ancestors.