Esophageal Resection Surgery

Background 

Esophageal Resection surgery as the name suggests involves surgery of the colon either by conventional open surgery or minimal access surgery also called as laparoscopic surgery . The laparoscopic surgery is performed by placing the specialised instruments in the abdomain and performing surgery on the monitor under complete vision. The minimal invasive surgery is established way of performing Esophageal surgeries which are well support various research and clinical based evidences. 

Esophageal surgeries are considered to be major surgeries and involves appropriate team work. With the advancements of techniques and improvisation of surgical skills  the surgical results of major Esophageal resections have become excellent with time. The extreme benefit with minimal invasive surgery for oesophageal disease is enhanced pulmonary functions after surgery when compared to conventional surgery.

The types of colon surgery performed either via open conventional surgery or laparoscopic surgery are Thoraco-Laparoscopic esophagectomy, Trans hiatal esophagectomy, Thoraco-Laparoscopic Esophageal gastrectomy,  Esophageal cardiomyotomy and  Esophageal perforation repair. 

Indication of Esophageal surgery 

  1. Esophageal cancers
  2. Esophageal  divertuclar disease 
  3. Achalasia cardia 
  4. Short oesophagus
  5. Sigmoid oesophagus 
  6. Esophageal strictures 
  7. Corrosive injuries of oesophagus  

Technical Insights 

Once you are planned for surgery the surgeon will explain all the details , it’s risk involved , informed consent and recovery protocols after  the surgery they are  planning to perform. Usually the length of the procedure will depend upon the extent of the surgery.  

  1. Surgery is performed under General anaesthesia
  1. Particular position of the patients according to the area of the surgery is given to the patient . This surgery require two phases in cases where performed by both laparoscopic and oesophageal means. The thoracic part is performed in prone or semi- prone position in laparoscopic surgey. The abdominal part is done commonly done in supine position and position is changed during the surgery depending upon the ease to perform surgery. 
  1. Technically incision is given upon extent of surgery and preference of surgery in cases of open conventional surgery 
  1. In laparoscopic surgery, Small hole are made to enter the abdomain using video scope to assess the complete thoracic and abdominal cavity along with  area of the disease.
  1. Mobilisation of the entire length of the  oesophagous  is done in the whole length up to neck. 
  2. Surgery is performed using specialised instruments, energy sources , clips , staplers  to separate the diseased oesophagous with part of stomach with healthy margins. The continuity of the alimentary canal is restored using staplers and sutures. 
  1. The diseased part is removed and the chest and abdominal drain    is placed  in abdominal cavity.
  2. Please note the extent of surgery can be different in various diseases. 

Recovery after surgery 

  1. The patient is kept in surgical intensive care unit for initial observation and management. Bleeding, infection, pneumonia, leak are major risks involve after these surgeries. 
  1. Intensive physiotherapy is advised for enhanced recovery of the patients as breathing might be hampered because of long incisions in case of open surgery  and pain associated with them. 
  1. Diet is usually started once your bowel function starts returning after surgery . 
  1. Early mobilisation of the patient is recommended.
  1. Routine check up up of your blood will be performed to study your recovery  and chances of infection. 
  1. Diet is managed with the help of the dietician to enhance your recovery and protein supplements are added.

Advantages of Laparoscopic oesophageal  surgery 

  1. Big incision  is avoided which is used in conventional surgery which causes significant discomfort and pain.
  2. Preserved Pulmonary functions after surgery. 
  3. Early recovery of bowel  functions 
  4. Early healing of the wound
  5. Shorter stay of hospital 
  6. Early mobilisation and early return to work 
  7. Scar is minimal 

To consult with best team of General, minimal access, cancer  and Thoracic surgeons available at  The Surgeons House (SHL) in different global locations, please click this link for more details. 

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