Laparoscopic Esophagectomy Dr. Satish Pattanshetti M.S(Gen. Surg), F M A S Dr. Neeraj V Rayate Director and Principal Surgeon

What is Laparoscopic Esophagectomy? Minimally invasive esophagectomy is surgery to remove part or all of the esophagus. This is 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. The surgery may also be done to treat the esophagus if it is no longer working to move food into the stomach.

Procedural Details Before surgery, the patient will be on a restricted diet for several days. On the day of surgery, the patient will be sedated and given a general anesthetic. Barring complications, the esophagectomy takes about six hours, on average. Operating laparoscopically, the surgeon makes five small incisions in the patient’s upper abdomen, through which he manipulates instruments. The surgery has several stages, typically working from the lower structures (the stomach) to the esophagus. If the stomach is to replace the esophagus, the stomach is divided, with some tissue removed and the remainder reshaped and sutured to create a more tubular structure. The diseased or damaged esophagus is then removed and the stomach connected to the remaining upper esophagus.

Medications Post-operative medications typically include narcotics for pain relief. Patients might be prescribed medication to control nausea and reduce the stomach’s production of acid.

What are the risks of having this procedure? The procedure can result in major complications such as leakage at the esophagectomy suture sites, and minor complications such as atrial fibrillation, pneumonia, lung collapse, bowel obstruction and loss of function to the diaphragm. With any surgery emerge risks of bleeding, infection and adverse reaction to anesthesia.

What are the risks of not having this treatment/procedure? In the absence of surgery, esophageal cancer is difficult to treat successfully occasionally some patients may be candidates for endoscopic removal or treatment with chemotherapy and radiation alone. However, for most patients with esophageal cancer, surgery offers the best chance of cure. A cancer that is not appropriately treated is nearly uniformly fatal. Patients with cancer diagnoses should seriously consider a physician’s recommendation of esophagectomy as life-extending and potentially life-saving.

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