Robotic Esophageal Surgery (Benign Conditions)

Robotic Surgery for Esophageal Diverticulum, Achalasia, GERD and Hiatal Hernia

NYU Langone’s thoracic surgeons are now performing robot-assisted procedures for a growing number of benign conditions of the esophagus (the long tube connecting the back of the throat to the stomach). Robotic surgery is ideally suited for these conditions, since it allows full access to the esophagus through a series of pencil-sized incisions in the abdomen or in the chest wall, without the need for a large abdominal incision—resulting in less post-operative discomfort and scarring and faster recovery.

The robotic esophageal procedures offered at the NYU Robotic Surgery Center include:

Resection of esophageal diverticulum
An esophogeal diverticulum is a protruding pouch in the esophagus, caused by a weakness in the esophageal lining. Symptoms may include regurgitation of food and difficulty swallowing. In this procedure, the weak area of the esophagus is surgically removed and the remaining parts of the esophagus are joined together.

Esophageal myotomy for achalasia 
Achalasia is a motor disorder of the esophagus that affects the lower esophageal sphincter (LES)—the valve between the esophagus and the stomach. As a result, the LES is unable to relax while the rest of the lower esophagus is unable to contract properly to propel food downward, making it difficult for food to pass into the stomach. Symptoms include difficulty swallowing, food regurgitation, and chest pain. People with this condition are also at heightened risk for pneumonia and other pulmonary infections from inhaling undigested food particles into their lungs. In a robotic myotomy, the surgeon cuts through the outer layers of esophageal muscle, thereby allowing the LES to open normally. This procedure is effective for the large majority of achalasia cases.

Robotic fundoplication for GERD/acid reflux and hiatal hernia 
In gastroesophageal reflux disease (GERD), stomach acid flows upwards into the esophagus, causing burning chest pain commonly known as heartburn. Other symptoms may include coughing and hoarseness, difficulty swallowing, and regurgitation of food. Over time, GERD can cause damage to the esophageal lining and may also increase risk of esophageal cancer. In robotic fundoplication, the surgeon wraps the top portion of the stomach (called the fundus) around the point where the esophagus meets the stomach, creating a barrier that prevents acid from flowing up into the esophagus while still allowing food to pass downward. Robotic fundoplication can also used to repair a hiatal hernia, in which the stomach protrudes up through a small opening in the diaphragm muscle called the hiatus.

Robotic Esophageal Surgery at NYU Langone

NYU Langone Medical Center is currently one of the few hospitals in the Northeast to offer robot-assisted esophageal procedures. Our thoracic surgeons are already among the most experienced in the world at minimally-invasive approaches to esophageal surgery. Now, Dr. Costas Bizekis and Dr. Michael Zervos are extending this expertise to include the use of robotic technology for a growing number of esophageal conditions, including esophageal cancer as well as benign conditions such as esophageal diverticulum and gastrointestinal reflux disease (GERD).

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