Esophagectomy - minimally invasive
Definition
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.
Alternative Names
Minimally invasive esophagectomy; Robotic esophagectomy; Removal of the esophagus – minimally invasive
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 3 to 4 small incisions (cuts) in your upper belly, chest, or lower neck. These cuts will be less than a ½-inch long.
- The laparoscope, with a camera on the end, will be inserted through 1 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 part of your stomach with staples and cut this section off. This part of your stomach will be used to form a new section of your esophagus. It will replace the part of your esophagus that will be removed.
- Your surgeon will remove the part of your esophagus where your cancer or other problems are.
- 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 at the lower part of your neck.
Some medical centers do esophagectomies using robotic surgery. In this type of surgery, a small camera and other instruments are inserted through the small incisions. 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 around 3 hours.
Risks
Esophagectomy is major surgery and has many possible risks. Some of them are serious. You should discuss these risks with your surgeon.
The risks from this surgery, or for problems after surgery, may be greater than normal if:
- You are unable to walk even for short distances. This increases the risk of blood clots, lung problems, and pressure sores.
- You are an older child who is still growing.
- You are older than 60 to 65.
- You are a heavy smoker.
Risks for any anesthesia are:
- Allergic reactions to medicines
- Breathing problems
Risks for any surgery are:
- Blood clots in the legs that may travel to the lungs
- Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney
- Blood loss
- Heart attack or stroke during surgery
Risks for this surgery are:
- Injury to the stomach, intestines, lungs, or other organs during surgery
- Leakage of the contents of your esophagus or stomach where the surgeon joined them together
- Narrowing of the connection between your stomach and esophagus
Reviewed By: Robert A. Cowles, MD, Assistant Professor of Surgery, Columbia University College of Physicians and Surgeons, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
