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Laparoscopic Oesophagus Surgery

DrGanesh DP 2
Dr Ganesh Ramalingam

Specialist in General Surgery

Procedure

Laparoscopic Stomach Surgery In A Nutshell

  • Laparoscopic oesophageal surgery is typically used to treat cancer of the oesophagus.
  • The procedure can be done as an open surgery or laparoscopically. However, laparoscopic oesophageal surgery has a lowered risk and a faster recovery rate.
  • Laparoscopic oesophageal surgery can also be used to remove tumours within the oesophageal walls before they evolve to become cancerous.
  • In serious cases where the cancer has spread, parts of the oesophagus along with the upper part of the stomach may be removed, this is known as oesophagogastrectomy.
  • Downtime: No physical or strenuous activities for 1 month. Allow your body to rest. For recovery time, our doctor will advise you in detail.

Table of Contents

Laparoscopic Oesophagus Surgery

What Is Surgery For Oesophageal Cancer?

In early stage oesophageal cancer, surgery to remove cancer is usually used as the main mode of treatment. In later stages oesophageal cancer, surgery is usually used in combination with other treatments such as chemotherapy or radiotherapy. Depending on how advanced the cancer is, surgeries to treat oesophageal cancer include:

  • Surgical removal of tumours which are very small. If your tumours are very small and confined to the outer layers of your oesophagus, your surgeon may remove the cancer and margin of healthy tissue surrounding it. Surgery is performed by an endoscope passed down your throat and into your oesophagus.
  • Surgical removal of part of your oesophagus, which is known as esophagectomy. Your surgeon removes the part of your esophagus which contains the tumour, together with a portion of the upper part of your stomach, and nearby lymph nodes. The remaining oesophagus is reconnected to your stomach.
  • Surgical removal of part of your oesophagus and the upper portion of your stomach, which is known as oesophagogastrectomy. Your surgeon removes part of your oesophagus, nearby lymph nodes and a huge portion of your stomach. The remaining stomach is then reconnected to your esophagus. Part of your colon may be used to help join these organs.

How Serious Is Surgery For Oesophageal Cancer?

Surgery for oesophageal cancer usually involves removing part of the oesophagus. In some cases, the entire oesophagus may need to be removed. This type of surgery is called a total oesophagectomy. 

Surgery for oesophageal cancer can be complex, and it is important to consult with a surgeon with experience in treating this condition. The team at G&L Surgical Clinic is familiar with the treatment of and surgery for oesophageal cancer, and we will work with you to ensure that you receive the necessary information to decide on your course of treatment.

What Are Potential Side Effects From Oesophageal Cancer Surgery?

Surgery is the most common treatment for oesophageal cancer.

With that said, there are a variety of potential side effects that can result from oesophageal cancer surgery. One of the most common is damage to the nerves that control the muscles in the throat.

This can lead to difficulty swallowing, hoarseness, and a feeling of a lump in the throat. In some cases, patients may also need to undergo speech therapy to regain their voice. Additionally, scar tissue can form around the incision, which can lead to pain and difficulty eating.

Patients may also experience GERD or heartburn as a result of surgery.

However, these side effects are typically temporary and will improve over time. With proper care and monitoring, patients can expect to make a full recovery following oesophageal cancer surgery.

What Are The Types Of Surgery For Oesophageal Cancer?

Open surgery and laparoscopic (keyhole) surgery can both be used, depending on the location of the cancer in your oesophagus. Open surgery is used in most cases.

In open surgery, your surgeon can make a cut into your neck, chest or stomach. Two cuts are made to reach your oesophagus. In trans hiatal oesophagectomy, which means operation is done through a cut in your neck and stomach. In trans thoracic oesophagectomy (known as Ivor Lewis operation) which is when the operation is done through cuts in your abdomen and chest.

In laparoscopic surgery, four to six small cuts are made in your stomach. A long tube called a laparoscope is used. It is connected to a camera which shows your internal organs through a video screen. This helps your surgeon put in instruments into your body through the other incisions. Using the laparoscope and the other instruments, your surgeon frees the stomach so that it can be moved into the chest. The tumour is removed and your stomach joined to the remaining oesophagus.

The cut with open surgery is usually in the chest (thoracotomy), on your side. Laparoscopic surgery takes around 6 to 8 hours and is longer than open surgery.

What To Expect?

  • Stop smoking one week before the procedure to decrease risk of breathing difficulty and infection after the surgery.
  • Stop taking certain medications a week before the procedure.
  • Do aerobics exercises for around an hour every day to build up your strength so that you will be able to recover more quickly after surgery.
  • Do breathing and coughing exercises every day to help expand your lungs.
  • Eat a healthy and balanced diet.
  • Drink only clear fluids two days prior to the procedure.
  • You may be administered a fleet to help you clear your bowels.
  • Fast as instructed by your doctor.
  • You will be given anaesthesia through an IV line to help you fall asleep.
  • Once you are asleep, a breathing tube will be placed down your mouth into your windpipe. This helps you breathe.
  • You will also have a urinary catheter to collect urine from your bladder.
  • When the surgery is completed, your incisions will be closed with stitches and your breathing tube removed.
  • You may have several tubes attached to you when you wake up. These tubes help to drain fluids out of your body and deliver painkillers and required nutrients until you are able to eat again.
  • A feeding tube may be necessary if your oesophagus is completely removed or there is significant scarring and narrowing after surgery.
  • Otherwise, you may consume your regular diet after a month. Do note that you may have to eat smaller amounts due to the reduced size of your stomach.
  • You may be given nutritional supplements.
  • You may be discharged from the hospital one to two weeks after the surgery.
  • You will be able to return to normal activities within three weeks.
  • Fix a follow up appointment with your doctor one week post-surgery.

What Happens After Oesophageal Cancer Surgery?

Oesophageal cancer surgery is a major operation. You will be in hospital for at least a week, and it will be several weeks before you fully recover. The type of operation you have will depend on the stage of your cancer and where it is in your oesophagus. The most common type of operation is an oesophagectomy (removing part or all of the oesophagus). 

After your operation, you will need to stay in the hospital for several days. During this time, you will be closely monitored by our medical team. You will also have a tube inserted into your stomach to help drain any excess fluids. Once you are discharged from the hospital, you will need to take things easy for at least six weeks. During this time, you should avoid strenuous exercise or lifting heavy objects. You will also need to follow a soft diet for several weeks after your operation. 

This means avoiding spicy food, fatty food and hard or crunchy food. After six weeks, you can gradually start to eat more normal foods again. However, it is important to eat small meals slowly and chew your food well. You may also need to take medication to control any indigestion or heartburn. 

Oesophageal cancer surgery can be a very successful treatment for early-stage cancers. The chances of being cured are much higher if the cancer is caught early. However, even if the cancer has spread to other parts of the body, surgery can still be helpful in controlling the disease and relieving symptoms.

What Foods Should Be Avoided After Oesophageal Cancer Surgery?

After oesophageal cancer surgery, it is important to avoid certain foods to give the body time to heal. Foods high in acidity, such as citrus fruits and tomatoes, can irritate the incision site and delay healing. 

Foods that are difficult to digest, such as fried foods and fatty meats, can also strain the digestive system. 

In addition, carbonated beverages and alcohol can cause bloating and discomfort. It is best to avoid these foods for at least the first few weeks after surgery. 

Instead, focus on eating soft, bland foods that are easy to digest. Soups, stews, cooked vegetables, and plain rice or pasta are all good options. As you start feeling better, you can slowly introduce other foods into your diet.

How Is The Quality Of Life After Oesophageal Cancer Surgery?

After oesophageal cancer surgery, the quality of life largely depends on the success of the surgery in removing all traces of cancer. If all cancerous tissue is successfully removed, the chances for a full recovery are good. 

However, if even a small amount of cancerous tissue is left behind, it can grow and spread quickly, leading to a decrease in the quality of life. In addition, many patients experience side effects after surgery, such as difficulty swallowing, which can make it difficult to eat and enjoy meals. 

Despite these challenges, however, many patients are able to lead happy and fulfilling lives after surgery. Patients can often regain their strength and enjoy their favourite activities with proper treatment and support.