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Esophageal surgery is performed to treat esophageal cancer, gastroesophageal reflux disease (GERD), motility disorders such as achalasia, and esophageal diverticula (weak areas of the esophagus that bulge or pouch outwards.)
Benign esophageal diseases tend to deal with motility problems, or how food moves through the esophagus. Achalasia is a common motility problem where the sphincter at the bottom part of the esophagus – the valve between the end of the esophagus and the beginning of the stomach – is permanently closed. Food can pass through, but it never really opens up. Achalasia can be treated surgically through a procedure called a myotomy, which can be done either laparoscopically or with the da Vinci® robotic surgical system, both of which are done by the thoracic surgeons at Froedtert & The Medical College of Wisconsin. If, on the other hand, the sphincter is not strong enough and is always open, patients suffer from GERD (heartburn). While many of these patients can be treated medically, when symptoms are severe, a surgery called a Nissen Fundoplication is very effective in controlling symptoms. This procedure can be done in a minimally invasive fashion using either the laparoscope or the da Vinci® robotic surgical system.
Benign esophageal tumors can also be treated surgically. The most common type of benign esophageal tumors are called leiomyomas, and they generally occur in smooth muscle.
Another benign condition called paraesophageal hernia occurs when a portion of the stomach goes up into the chest next to the esophagus. The surgery to repair a paraesophageal hernia may be done laparoscopically or using the da Vinci® robotic surgical system, although a traditional open surgical method may also be used.
The two most common types of esophageal cancers are adenocarcinoma and squamous cell carcinoma. Some patients may require an esophagectomy, or surgical removal of the esophagus as part of their overall treatment. Multidisciplinary treatment is crucial for the esophageal cancer patient. While our surgeons have unmatched expertise in performing esophagectomies, that is not enough on its own. Esophageal cancer patients often need to be seen by a radiation oncologist, a hematologist/oncologist, a gastroenterologist, a radiologist, a nutritionist and a speech pathologist, for example. We take a true team approach to comprehensive patient care and have an entire system of specialists, all on our campus, who understand the patient’s needs throughout this disease process.
Another condition, called Barrett’s esophagus or Barrett’s dysplasia, is considered precancerous and may or may not require esophageal surgery. Barrett’s esophagus results from long-term GERD. Not all patients with GERD get Barrett’s, but nearly all patients with Barrett’s have GERD. If other treatment options fail, there are surgical options to treat GERD and Barrett’s esophagus in certain cases. One anti-reflux surgical procedure, the Nissen Fundoplication mentioned earlier, can be done laparoscopically.
Whether the cause is benign or malignant, esophageal surgery can be done different ways, depending on the individual patient’s needs and condition. In many cases, surgery can be done with minimally invasive techniques using the da Vinci® robotic surgical system, a laparoscope or video-assisted thoracic surgery (VATS). Our surgeons are skilled in all of these techniques, which translate into smaller incisions, less pain, quicker recovery times and other benefits for patients.
At Froedtert & The Medical College of Wisconsin, patients receive the highest quality, most comprehensive, multidisciplinary care that is tailored to their individual needs.
Author: Joan Cotter Pike Date: Nov. 30, 2006 |
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