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Robotic-assisted surgery

  • Robotic-assisted surgery photo tour

    The photo tour below will explain and illustrate what will happen during your surgery.

    1. To begin, click on the first image below.
    2. Select the "Next" button in the top right of the image to advance to the next image.

     

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    This is what your surgery room set up will look like.  Your surgeon will perform the surgery using the da Vinci® Surgical System. The exact locations of the ports in your abdomen can change.  Yours may not be in the spots pictured.  Before surgery you will receive anesthesia to make you fall asleep. You will lie on your back on a surgery table.The surgeon will make five incisions in your abdomen, about the size of a dime. These incisions are called laparoscopic ports. The surgeon will use the video camera, robotic instruments and other medical instruments through the ports. The robotic instruments and camera allow the surgeons to perform surgery in your chest through ports in your abdomen.  This means you will not have chest incisions.  Using the robotic instruments, the surgeon will loosen (or free up) the esophagus by going through the natural opening in the diaphragm (hiatus). The blood supply to the gastric tube is preserved.  After the esophagus and lymph nodes have been freed up, the surgeon will start to divide the stomach. The section of stomach being divided to connect with the remaining esophagus is called the gastric tube. The upper part of the stomach will be removed with the esophagus.  The surgeon will finish dividing the stomach. The gastric tube will be in the space where the esophagus had been.  The surgeon will attach a temporary Penrose drain from the esophagus to the gastric tube to help pull the gastric tube up to the neck. A special stapling device is used to connect the gastric tube to the upper part of the esophagus.  The surgeon will make an incision on the left side of your neck. Through this incision, the surgeon will remove the resected esophagus and upper stomach. The feeding tube will be placed into the jejunum (the upper part of the small intestine). The stomach is attached to the esophagus. (The connection is known as the anastamosis.) The surgeon will insert a thin, flexible feeding tube into the upper part of the small intestine. This is called a jejunostomy tube and will be used to provide nutrition during your recovery. This completes the surgery.

  • Medical robot treats esophageal cancer

  • Risks/complications of surgery

    As with any surgery, there are possible risks and/or complications involved. These can include the following:

    • general anesthesia risks
    • bleeding that requires a blood transfusion or another surgery
    • leak from anastamosis (surgical connection)
    • vocal cord injury causing voice changes or problems with swallowing (This is usually temporary.)
    • infection at an incision site
    • pneumonia
    • other respiratory problems that require breathing support
    • heart attack, stroke or blood clots
    • weakness, loss of muscle strength that requires rehabilitation
    • scarring or tightening of the new connection between the stomach and esophagus, known as stricture (Many patients need at least one - possibly several - stretching procedures to keep the connection open.)
    • the possibility that the cancer can't be removed
    • other

    You may have others that are not on this list. Please talk with your surgeon about any concerns or questions you have.