ESOPHAGEAL SURGERY

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Esophagus is a hollow muscular tube that extends from the throat, travels through the chest cavity and enters the abdomen to join the stomach. As you all know it assists in transferring food consumed from the oral cavity to the stomach, where the process of digestion starts.

ESOPHAGEAL SURGERY

Surgery on the esophagus is different and tricky compared to other structures of the gastrointestinal tract because of the location of the esophagus within the chest cavity, where all important structures like heart, lungs and major blood vessels lie close together.

  Important surgical conditions that warrant surgery on the esophagus include

Gastroesophageal reflux diseaseAchalasia Cardia Esophageal cancerBenign tumours like leiomyoma

 APPROACH TO ESOPHAGEAL SURGERY

The surgery on the esophagus may include different approaches

  1. Conventional open approach – Here the surgeon makes long cuts in the abdomen or on the sides of the chest and performs procedures on the esophagus
  1. Laparoscopic or Thoracoscopic approach ( minimally invasive surgery)- Instead of a large incision or cut, surgery is performed through small incisions approximately 1 cm in length with the use of special instruments and a telescope( to visualize the internal organs) and video monitor. The surgeon operates by seeing the structures within the chest or abdomen are seen on the video monitor.

Today, a lot of patients prefer laparoscopic or minimally invasive methods of treatment over the conventional open incision methods. There are quite a lot of advantages of going in a minimally invasive procedure.

  • Several incisions are made against one single painful incision.
  • Recovery period is faster, when endoscopic or laparoscopic methods of treatment are used.
  • You can get back to your normal life faster.
  • Results are equivalent to the conventional open surgery.

    The main diseases that would require surgery in Esophagus include 

    GERD- Gastro Esophageal Reflux Disease

    Here, you have acid juices from your stomach refluxes into your esophagus. You feel as if the food you eat keeps coming back. The common symptom associated with GERD is a heart burn. You may be able get rid of GERD symptoms by making certain life style changes and effective medicines. If you cannot get relief from medicines and life style changes you will need surgery, which involves tightening the valve mechanism that prevents food from refluxing back into the stomach.Laparoscopic Nissen’s fundoplication is a very effective surgical procedure that is performed world over in a patient with typical GERD, that helps you to stop lifelong medicine intake. 

     Achalasia Cardia

    The Lower Esophageal Sphincter fails to open up, while you swallow your food. Because of this, you have a heavy back-log of food lying within the esophagus. This is known as an Achalasia Cardia. You will feel food getting stuck in your chest and sense of choking in the night while you are asleep. The treatment involves medicines, endoscopic dilatation of the sphincter or surgical division of the sphincter muscle among which surgery gives best long lasting relief from symptoms. Here Laparoscopic Heller’s Myotomy is the surgery that’s commonly recommended and performed, requires a hospital stay of 3 – 4 days and is associated with excellent long term results. Esophageal Cancer

    • There are two types of cancer of esophagus - Squamous cell carcinoma and Adenocarcinoma . Difficulty in swallowing is the predominant symptom of carcinoma esophagus. Esophagectomy or surgical removal of the esophagus is the preferred treatment option in physically fit patients who are fit to undergo surgery. Surgery may be performed through laparoscopy or thoracoscopy or conventional open method. The esophagus is removed and the stomach or large intestine will be brought up into the chest to act as substitute for the esophagus and enable the patient to eat normally. Both laparoscopic and open surgery are associated with similar long term results with regards to cancer related outcome. Laparoscopy has a faster recovery time as mentioned earlier.

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