Esophagectomy - minimally invasive - Overview

Definition of Esophagectomy - minimally invasive:

Minimally invasive esophagectomy is surgery to remove part or all of the esophagus, the tube that moves food from your throat to your stomach. After it is removed, the esophagus is rebuilt from part of your stomach or part of your large intestine.

Most of the time, esophagectomy is done to treat cancer of the esophagus.

Description:

There are many ways to do this surgery. Talk with your doctor about what type of surgery is best for you. It will depend on where in your esophagus your cancer is, how much it has spread, and how healthy you are.

Laparoscopy is one way to do this surgery:

• Your surgeon will make three to four small cuts in your upper belly, chest, or lower neck. These cuts will be less than ½-inch long.
• The laparoscope, with a camera on the end, will be inserted through one of the cuts into your upper belly. Video from the camera will appear on a monitor in the operating room. Other medical instruments will be inserted through the other cuts.
• Your surgeon will close off one part of your stomach with staples and cut this section off. This part of your stomach will be used to form a new tube to replace the part of your esophagus that is removed.
• Your surgeon will remove the part of your esophagus where your cancer is located, and any other related lymph nodes in the area.
• Your surgeon will join together your rebuilt esophagus and stomach in your neck or chest. Where they are joined will depend on how much of your esophagus was removed.
• Lymph nodes in your chest may also be removed if your cancer has spread to them. Your surgeon will remove them through a cut in the lower part of your neck.
• Your surgeon will place a feeding tube in your small intestine so that you can be fed while you are recovering from the surgery.

Some medical centers do esophagectomies using robotic surgery. In this type of surgery, a small camera and other instruments are inserted through small cuts in the skin. Your surgeon will do the surgery while operating a computer and watching the monitor. The surgeon controls the instruments and camera with a computer program.

See also: Robotic surgery

These surgeries usually take 3 - 6 hours.

Why the Procedure Is Performed:

The most common reason for removing part, or all, of your esophagus is to treat cancer. You may also have radiation therapy or chemotherapy before or after surgery.

Surgery to remove the lower part of your esophagus may also be done to treat:

• Achalasia, a condition in which the esophagus doesn’t work well
• Pre-cancerous changes in the tissue of your esophagus, called high-grade dysplasia (Barrett's esophagus)
• Severe trauma