Esophageal Treatments
Endoscopy (EGD)
Endoscopic Mucosal Resection (EMR)
En Bloc Esophagectomy
Endoscopic Ultrasound (EUS)
Laparoscopic Esophagectomy
Laparoscopic Heller Myotomy
Laparoscopic Nissen Fundoplication
Transhiatal Esophagectomy
Vagal Sparing Esophagectomy
Esophageal manometry
pH probe study
Vagal Sparing Esophagectomy
What is a Vagal Sparing Esophagectomy?
A Vagal Sparing Esophagectomy is done in patients who are being treated for end-staged achalasia or early-staged cancer of the esophagus. It differs from other esophageal surgery because it preserves the vagus nerves. These nerves are important for normal stomach function. Preserving theses nerves allows the stomach to empty. The surgery is done through the abdomen and the neck. Five small incisions less than 5 mm a piece are placed on the abdominal wall and small incision is placed in the left neck. A 10mm camera is placed through one of the incisions and surgical instruments are placed through the other four. The stomach and esophagus are mobilized and the stomach is cut into the shape of a tube using surgical staples. The esophagus and cut portion of the stomach are pulled out through the neck incision and removed. The newly shaped stomach is brought up through the chest and sewn to the small piece of the esophagus that is left behind in the neck.
Will I need to have anesthesia?
Yes.
How long will it last?
The surgery takes about 4-6 hours.
Will anything be removed, replaced, etc?
Yes, the esophagus is removed and replaced with the stomach.
Where will the incision(s) be made?
Five small incisions, 10 mm in diameter will be made on the abdominal wall and a small incision will be made in the left neck.
Will any devices/sutures/staples be implanted and will they need to be removed?
Permanent sutures will be used to sew the esophagus to the stomach and surgical staples will be used to fashion the stomach into a tube.
Will I have any tubes or drains after surgery?
Yes, you will have a small tube coming out of your nose that drains the fluid in your stomach. It will be removed 5 days after surgery. A small drain will be in your neck and will be removed 1-2 weeks after surgery in the doctor's office. You will have a small feeding tube in your stomach that you will go home with and use it to supplement your nutrition and provide medications. It will be removed approximately 2 months after surgery once you are eating well and gaining weight.
How long is the stay in the hospital?
You will need to stay in the hospital for 5-10 days. You may spend 1-3 nights in the intensive care unit depending on how well you recover.
How long before I will be eating solid foods?
For the first week after surgery you will be drinking liquids only. In the second week you will start to eat soft foods. By 2 months you can eat a normal, but sometimes restricted diet.
How long before I am back to my normal levels of exercise?
It is recommended that you refrain from strenuous activities and heavy lifting for about 2 months. You may return to work after 4 weeks if your work does not require heavy lifting or strenuous activities.
When will I be back to my normal routine?
Usually by 2 months you can return to your normal routine.
What follow up is necessary?
A follow up visit 2 weeks after surgery is necessary and again at 3 months after surgery. Further follow up is at the discretion of the surgeon.
How will this affect my life in the long-term?
After some time your life will return to normal. You will always notice a change in your bowel habits including looser stools and more frequent meals. You may notice that some foods are more difficult to eat than others. Your doctor will advise you as to what foods to avoid.
However, some permanent alterations in lifestyle are recommended.
| 1) |
Small frequent meals, avoiding steak or heavy meats. |
| 2) |
Elevate head of bed 30 degrees at all times. |
| 3) |
Sitting in a chair following meals for at least one hour. |
