A specialist clinical monograph for thoracic and general surgeons who specialise in the treatment of esophageal cancer, supported by practical images and video. Esophageal cancer is a challenging area which includes the specialties of gastro-hepatology, radiology, radio-chemotherapy, anesthesia, psychology and surgery, requiring treatment by a multidisciplinary team. In this type of surgery tumors located in the middle and upper 1/3 present a particular challenge, so the author describes how the use of the ‘Akiyama procedure’ can alleviate this, maximising operative access. This content is suitable for practising surgeons with a range of surgical experience, and the step-by-step approach is fully illustrated with both photographs and access to operative videos. Key points are described, and potential pitfalls explained.