Leading-Edge Surgical Treatment for Esophageal Disorders

The thoracic surgeons at Lahey Hospital & Medical Center are experts in treating disorders affecting the esophagus (the tube that runs from the throat to the stomach). Many procedures that in the past required open surgery with large incisions can now be performed with minimally invasive techniques. This can result in less pain, a faster recovery and a shorter hospital stay.

Swallowing Difficulties (Achalasia and Esophageal Narrowing)

Achalasia is a condition in which the nerves of the esophagus become damaged. It can cause chest pain, difficulty swallowing, heartburn and other symptoms.

Lahey’s thoracic surgeons treat achalasia with minimally invasive laparoscopic techniques, in which special thin instruments and a miniature lighted camera are inserted through tiny incisions. The camera sends images to a video screen, which the surgeons use to guide their progress. This state-of-the-art procedure, called laparoscopic Heller myotomy, produces excellent patient outcomes.

In certain situations, the surgeons at Lahey can treat achalasia using a cutting-edge completely “incision-less” procedure that is performed endoscopically (using a thin camera placed down the throat). This procedure called POEM (Per-Oral Endoscopic Myotomy) produces little to no pain, rapid recovery, and excellent outcomes for patents with achalasia.

The esophageal team at Lahey has a variety of advanced techniques for treating esophageal narrowing, also known as “stricture” or “stenosis.” Esophageal narrowing can be caused from chronic acid reflux, injury, or infection. The thoracic surgeons at Lahey use esophageal endoscopy with dilation (gentle stretching procedure), stenting, and in certain circumstances, surgery to open the area of narrowing and improve a patient’s ability to swallow. Oftentimes, these procedures are performed as “Day Surgery” and the patient can go home the same day as the procedure.

GERD and Hiatal Hernia

In people with gastroesophageal reflux disease (GERD), stomach acid moves upward into the esophagus and causes heartburn. Symptoms of heartburn sometimes lead to long-term use of anti-acid medications. Unfortunately, these medications often become ineffective with prolonged use, are costly, and over time, this acid can damage the tissues of the esophagus and lead to cancer.

GERD is often caused by hiatal or paraesophageal hernia. In these conditions the stomach, and lower part of the esophagus, slip from the belly into the chest. This can create pain and acid reflux.

At Lahey Hospital & Medical Center, our thoracic surgeons use minimally invasive laparoscopic techniques to repair hiatal hernias and eliminate GERD. In this procedure, the surgeon uses tiny incisions to introduce cameras and small instruments laparoscopically to reposition the esophagus and stomach in the proper place and create a valve to stop acid reflux. Lahey thoracic surgeons also use advanced robotic surgery to treat these esophageal conditions.

Barrett’s Esophagus and Esophageal Cancer

At Lahey Hospital & Medical Center, a multidisciplinary team of gastroenterologists and thoracic surgeons have extensive expertise in caring for patients with esophageal cancer and the pre-cancerous Barrett’s esophagus.

Our doctors use high-definition endoscopy (a lighted scope inserted down the throat while the patient is sedated) to examine the esophagus. If precancerous or cancerous tissue is found, it can often be removed at the same time, so patients do not have to go through any additional procedures.

If more extensive esophageal cancer is found, Lahey’s thoracic surgeons can treat it with an advanced procedure called esophagectomy. In this procedure, often performed with minimally invasive or robotic techniques, our surgeons remove all or part of the esophagus and then rebuild it from part of the stomach or intestine.

Minimally invasive esophagectomy uses a thin high-definition camera and small instruments to remove the esophageal cancer without requiring large and debilitating incisions. Lahey’s thoracic surgeons perform a large number of these esophagectomy procedures, and our experience has produced excellent outcomes for our patients.