Esophagectomy is a procedure in which a portion or the entire length of the esophagus is removed and replaced. Esophagectomy is usually used as an intervention for cancer or Barrett's dysplasia, but occasionally may be performed to treat benign disease such as esophageal atresia, achalasia, or injury to the esophagus, when the esophagus is no longer functional.
Minimally Invasive Esophagectomy (MIE)
NewYork-Presbyterian/Columbia surgeons perform Minimally Invasive Esophagectomy (MIE) and train surgeons around the world in MIE techniques. Approximately 80% of esophageal resections at our institution are performed minimally invasively. Just as in open surgery for esophageal cancer, MIE involves removal of the esophagus and lymph nodes.
How is Esophagectomy Performed?
In all esophagectomy procedures, the surgeon makes an incision in the abdomen, separates the esophagus from the stomach, and utilizes a portion of the stomach to fashion a replacement esophagus. Additional incisions are made in the chest and/or neck, depending upon the portion of the esophagus that is diseased, as well as the patient's anatomy:
- Trans-hiatal esophagectomy (THE) involves an incision in the abdomen as well as the neck. THE is generally performed for early-stage cancers and is routinely done minimally invasively.
- Ivor Lewis esophagectomy (also known as trans-thoracic esophagectomy, or TT) involves an incision in the abdomen as well as the chest. This procedure is employed when the tumor or cancerous tissues are located in the upper part of the esophagus.
- A three-incision option involves access to the abdomen, the chest, and the neck.
We perform all of these procedures using a minimally invasive approach, although open surgery may be more appropriate depending upon the patient's clinical characteristics and the location of the diseased portion of the esophagus.
Esophagectomy should be performed by a specially trained thoracic or general surgeon who performs this procedure on a regular basis.