An Esophagectomy is a type of surgery performed to remove all or most of the esophagus, usually because of esophageal cancer. The esophagus is the food passage that connects your mouth to your stomach. When the esophagus is removed, it is replaced by turning the stomach into a tube-like shape to make a new esophagus. We perform this surgery with the robotic platform, which means it is minimally invasive. Incisions are made both in your abdomen and the side of your chest. Having an esophagectomy will drastically change your diet after surgery. You will no longer be able to eat large meals, but need to eat frequent small meals.
Achalasia is a condition that affects the esophagus. Where the esophagus connects to the stomach there is a muscle called the lower esophageal sphincter (LES). When the LES is too tight (Achalasia), food cannot move from the esophagus into the stomach. This can cause the esophagus to become dilated or stretched and no longer straight. Symptoms of Achalasia that patients may experience include difficulty swallowing, sensation of food getting stuck in your throat, regurgitation of food, indigestion, choking, losing weight without trying and chest pain. Heller Myotomy is the surgical procedure used to treat achalasia by cutting the outer muscle layers of the lower esophagus in order to help solids/liquids pass easier by relaxing the lower esophageal sphincter.
There are several types of hiatal hernias, and a paraesophageal hernia is the most extreme type of hiatal hernia. In a paraesophageal hernia, the stomach is no longer in the abdomen, it is in the chest. Over time, these hernias can grow very large. The stomach and other abdominal organs (such as the intestine, spleen, and colon) may also bulge into the chest in a paraesophageal hernia. This can result in twisting (volvulus) of the stomach (possibly leading to gangrene), which requires emergency surgical treatment. Because of the risk involved in emergency treatment, it is generally recommended that all patients with this type of hernia undergo surgery regardless of the symptoms. Additionally, studies have shown that surgical repair of these hernias significantly improved associated symptoms such as: heartburn, trouble swallowing, regurgitation, and anemia. Paraesophageal hernia repair is done through a minimally invasive robotic approach to reduce (take down) the stomach back into the abdomen. This involves stitching the diaphragm tighter around the esophagus, so the stomach won’t migrate back up again. Hernia repairs are also often performed in conjunction with Nissen Fundoplication or LINX placements. These keep the stomach down in the abdomen and also prevent acid reflux after surgery.