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Esophagectomy - minimally invasive

Minimally invasive esophagectomy; Robotic esophagectomy; Removal of the esophagus - minimally invasive; Achalasia - esophagectomy; Barrett esophagus - esophagectomy; Esophageal cancer - esophagectomy - laparoscopic; Cancer of the esophagus - esophagectomy - laparoscopic

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.

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Description

During minimally invasive esophagectomy, small surgical cuts (incisions) are made in your upper belly, chest, or neck. A viewing scope (laparoscope) and surgical tools are inserted through the incisions to perform the surgery. (Removal of the esophagus can also be done using the open method. Surgery is done through larger incisions.)

Laparoscopic surgery is generally done in the following way:

Some medical centers do this operation using robotic surgery. In this type of surgery, a small scope and other instruments are inserted through the small cuts in the skin. The surgeon controls the scope and instruments while sitting at a computer station and viewing a monitor.

Surgery usually takes 3 to 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 esophagus may also be done to treat:

Risks

This is major surgery and has many risks. Some of them are serious. Be sure to discuss these risks with your surgeon.

Risks for this surgery, or for problems after surgery, may be higher than normal if you:

Risks for anesthesia and surgery in general are:

Risks for this surgery are:

Before the Procedure

You will have many doctor visits and medical tests before you have surgery. Some of these are:

If you are a smoker, you should stop several weeks before surgery. Ask your health care provider for help.

Tell your provider:

During the week before surgery:

On the day of surgery:

After the Procedure

Most people stay in the hospital for 7 to 14 days after an esophagectomy. How long you stay will depend on what type of surgery you had. You may spend 1 to 3 days in the intensive care unit (ICU) right after surgery.

During your hospital stay, you will:

After you go home, follow instructions on how to take care of yourself as you heal. You'll be given information on diet and eating. Be sure to follow those instructions as well.

Outlook (Prognosis)

Many people recover well from this surgery and can have a fairly normal diet. After they recover, they will likely need to eat smaller portions and eat more often.

If you had the surgery for cancer, talk with your doctor about the next steps to treat the cancer.

Related Information

Esophageal cancer
Esophagectomy - open
Gastrostomy feeding tube - bolus
Clear liquid diet
Esophagectomy - discharge
Diet and eating after esophagectomy

References

Filicori F, Swanström LL. Management of esophageal cancer. In: Cameron AM, Cameron JL, eds. Current Surgical Therapy. 13th ed. Philadelphia, PA: Elsevier; 2020:53-63.

National Cancer Institute website. Esophageal cancer treatment (PDQ) - health professional version. www.cancer.gov/types/esophageal/hp/esophageal-treatment-pdq. Updated July 15, 2021. Accessed July 30, 2021.

Rajaram R, Spicer JD, Dhupar R, Kim JY, Sepesi B, Hofstetter WL. Esophagus. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 42.

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Review Date: 1/19/2021  

Reviewed By: Mary C. Mancini, MD, PhD, Director, Cardiothoracic Surgery, Christus Highland Medical Center, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 07/30/2021.

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