Surgery for Esophageal Cancer

Esophageal cancer surgery is complex and requires performing surgeons to have specialized training and extensive experience to give patients the best post-surgery quality of life. We are one of the few centers in the Bay Area that performs a high volume of esophageal surgery using a minimally invasive approach, including a Robotic assisted approach.

Gastric Conditioning Procedure (Pre-Surgery)

We specialize in this sophisticated minimally laparoscopic pre-esophageal surgery procedure, which allows the surgeon to visualize the abdominal cavity and remove lymph nodes, but also prepares the stomach for the esophageal surgery by ensuring good blood flow to the area once the esophageal surgery is completed.

Oftentimes, esophageal patients receive neoadjuvant therapy before surgery, which uses a combination of chemotherapy and radiation treatment to reduce the tumor before surgery. At the time of the laparoscopic conditioning procedure, the surgeon will also place a stent in the patient’s esophagus which helps with swallowing. Most patients also have a feeding tube placed to ensure they are able to maintain their calorie intake during treatment. Patients may also have a venous access device (VAP/PORT) placed which is used for chemotherapy infusions.

Surgical Resection of the Esophagus

Surgery to remove the part of the esophagus with cancer is called an esophagectomy. During the esophagectomy, depending on the location and extend of your cancer, part of the esophagus or the entire esophagus will be removed. The stomach or in some cases part of the bowel will be used to rebuild your esophagus.

Our surgeons, who perform a high volume of esophagostomies, perform close to 100% of their procedures using the most minimally invasive Robotic-assisted approach. The benefit of minimally invasive Robotic-assisted esophagectomies include:

  • Robotic assisted approach allows the surgeon better visualization and dexterity while working around critical body structures 
  • Smaller incisions which produce less pain – less blood loss and lower complication rates and less morbidity
  • Less hospital time – patients generally are able to avoid time on the critical care floors and instead spend their entire recovery in a private room on a dedicated surgical floor. Most patients go home in 4-6 days which if far less than hospitals who have less experience and lower volumes of esophagostomies. (Agency for Healthcare Research and Quality (AHRQ) reports an average stay of 17.3 days hospitalization as the national average)

A multidisciplinary approach to your care continues throughout your hospital stay. Your care team includes you’re a board-certified thoracic surgeon, other physician specialist, a physician assistant, nurses, dieticians, respiratory therapists, case managers, discharge planners. Their collaborative approach is to make sure you are well informed during your post-operative recovery and well informed and comfortable with your discharge plan.