The surgery starts with a small cut (4 cm) on the left side of the neck near the muscle that runs from the collarbone to the ear, to access the esophagus.

The surgery involves carefully removing tissue around the esophagus and nearby lymph nodes in the lower chest area, working from multiple directions to avoid damaging important structures.

During the surgery, doctors remove lymph nodes near the voice box nerve and in the area between the aorta and pulmonary artery.