Minimally invasive esophagectomy is performed at Massachusetts General Hospital primarily for patients with esophageal cancer, but is occasionally used in treating benign esophageal conditions. During an esophagectomy, the diseased portion of the esophagus is removed, and the stomach is used to reconstruct the esophagus. Performing the surgery in a minimally invasive fashion allows for a quicker recovery with decreased pain. Minimally invasive esophagectomy begins after the patient receives general anesthesia. The surgeon makes five small incisions, known as ports, in the abdomen to perform the laparoscopic portion of the procedure. Using a camera for magnification, instruments are passed through the laparoscopic ports.
This process allows the stomach to be moved to replace the esophagus. In cases of esophageal cancer, extensive lymph node dissection is also performed. The portion of the stomach that will be used to reconstruct the esophagus is prepared to move into the chest. The stomach is moved to the chest, replacing the diseased portion of the esophagus. The patient is then turned and the surgeon makes four small incisions in the right side of the chest, avoiding spreading of the ribs. The esophagus is removed, and the stomach is sewn to the remaining esophagus.