Lap assisted Transhiatal Esophagectomy

Lap assisted Transhiatal esophagectomy for ca OG junction and lower esophagus

Esophagus is the tract through which food moves from mouth to stomach. It consists of many layers. Inner layer of esophagus is a layer of mucosa which keeps the inner part of the esophagus wet for the food to pass down easily. Tumors or cancerous cells growing on the inner part of esophagus can be dangerous to human life.
Esophageal cancer starts on the outer cells of the inner layer of esophagus and spreads to the outer


layers of esophagus and to the neighbouring tissues. This is a dangerous disease. Earlier diagnosis and removal of cancerous portion of the esophagus through surgery are the only cure for esophageal cancer. Transhiatal esophagectomy is the surgery done for the removal of tumors of the lower part of the esophagus. This is surgery is advisable only for patients in the early stages of esophageal cancer. In lap assisted transhiatal esophagectomy a laparoscope is inserted through a small incision near the naval. Through other small incisions in the abdomen, the instruments used for the surgery are inserted. The surgeon cuts the esophagus from the stomach through another incision about 4 cms wide in abdomen. The stomach is pulled through the hiatus in the diaphragm and connected to the cut portion of esophagus.
Another cut is made below the front side of the neck. Through this space the upper portion of the esophagus is cut. The cut portion of the stomach is pulled through hiatus, the hole in the diaphragm. For this purpose a tube inserted through the incision about 4 cms in diameter in the abdomen and is taken out through another incision in the front lower side of the neck. With the help of this tube, the stomach is pulled through hiatus. The stomach is then connected to the cut portion of the esophagus either by stitching or stapling, through the hole in the neck. 
This surgery is done under general anesthesia. The possibility of leaks in the internal suture is a probable risk factor of this surgery. Infection, bleeding, and problems connected with the functioning of the heart are the other possible risks of this procedure.
After the surgery patient may be required to spend more time in the hospital. Complications may develop after the completion of the surgery. Complete recovery may take more time which may extend to three to six months. 
A change in dietary habits will be advised by the surgeon. It is better to take small quantity of food which is less in fat content and spices. It is better to eat small quantities of food slowly and sit or stand upright for some time after the food intake.


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