Esophageal Surgery and Stents
The esophagus is a muscular tube that moves swallowed food from your throat to your stomach as part of the process of digestion. At the top, there is a band of muscle called the upper esophageal sphincter. When a person isn’t swallowing, these muscles contract to prevent stomach acid from getting into the esophagus. However, the aging process can cause these muscles to weaken, allowing the acid in, resulting in gastroesophageal reflux disease (GERD), which damages the esophagus.
Robotic antireflux surgery: When GERD patients are no longer getting relief from medication, this minimally-invasive procedure may correct the problem by placing a valve mechanism at the bottom of the esophagus. After surgery, you may have tubes or drains that collect urine or other fluids. You may be able to drink water the night of your surgery. The next day, you can have other clear liquids, gradually adding soft foods. It will take about three or four days to return to eating solid foods. Most patients are discharged from the hospital the day after surgery. You will need to care for your incision and attend all follow-up appointments.
Esophagectomy: This procedure is most often undertaken to treat advanced esophageal cancer and sometimes for Barrett’s esophagus if it is aggressively precancerous. The surgery removes all or part of the esophagus, replacing it with either the stomach or large intestine. This procedure can sometimes be done robotically, but otherwise conventional surgery is required. After robotic surgery, patients generally spend one night in intensive care, and remain in the hospital for about a week. Full recovery takes, on average, six to eight weeks. After this procedure, patients should eat frequent, small meals and sleep with their head slightly elevated. Patients need to attend follow-up appointments and follow doctors’ recommendations.
Robotic esophageal myotomy: This procedure is used to correct esophageal motility disorders. A motility problem is when the lower half of the esophagus doesn’t contract properly and food can’t be pushed into the stomach. Then, the valve at the organ’s bottom doesn’t open to allow food into the stomach. As this is a progressive disease, patients need to be treated endoscopically or with the generally more effective robotic surgical procedure. The surgery involves cutting the valve muscles between the esophagus and stomach to allow food through. The average hospital stay after this robotic procedure is one to two days, while open surgery may require a week stay.
Esophageal dilation/stent placement: This procedure is used to address narrowing of the esophagus, most often caused by scarring resulting from reflux. Other causes of esophageal narrowing include esophageal cancer, scarring caused by radiation treatment, a motility disorder or thin layers of excess tissue called rings. Patients with this issue have trouble swallowing, and it may feel like food is stuck in their chest. This procedure can be done as an endoscopy, placing fine wire mesh stents in the esophagus to expand the opening. Though the stents remain in place, they can be replaced if needed.
Conditions that may require esophageal surgery:
- Barrett’s esophagus
- Esophageal web
- Gastroesophageal reflux disease (GERD)
- Hiatal hernia
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