An esophagectomy is a surgical procedure to remove part of the esophagus. Nearby lymph nodes and a small part of the stomach may be removed as well. The remaining stomach is then pulled up to connect to the upper section of the esophagus.
Surgical removal of the esophagus has traditionally required a thoracotomy (an incision in the chest), as well as a laparotomy (abdominal incision). These incisions offer maximal exposure for the surgeon, but can cause significant postoperative pain and lung complications, including pneumonia.
At Weill Cornell Medicine, we strive to use minimally invasive surgical approaches—such as laparoscopy or video-assisted thoracoscopy—for patients with operable esophageal cancer (early esophageal cancer or dysplasia). During these procedures, telescopes placed through small incisions in the chest and abdomen are used to visualize, manipulate, and remove the esophagus and surrounding lymph nodes.
Minimally invasive surgery to remove the esophagus typically requires a shorter stay in the hospital compared to conventional open surgery. Also, patients who have minimally invasive esophagectomy typically experience less discomfort, require fewer pain medications, and recover more quickly.
Our patients benefit from:
• The most advanced techniques in surgical procedures including robotics, which enables greater magnification and more precision
• Our excellent network of medical professionals—including oncologists, gastroenterologists, and pathologists—working with our thoracic surgeons to ensure patients receive truly comprehensive care
• Treatments tailored specifically to our individual patients
• Our record of excellent outcomes—among the best in the nation—with very low rate of complications
• Expertise in operating on patients with other health problems (such as diabetes, kidney problems, or others) and those who are elderly
We recommend visiting the Weill Cornell Medicine Cardiothoracic Department website, as well as the National Cancer Institute and the Lung Cancer Research Foundation.
Once you and your care team decide that surgery is the best treatment plan for your condition, you will schedule a pre-surgical appointment at M404.
During your pre-surgical appointment:
● Your nurse practitioner will explain what you can expect for your specific surgery and hospital stay
● Your nurse practitioner will review your current medications
● You will sign a consent form for the surgery and potential blood transfusion (Please note: Most patients do not receive blood transfusions during surgery, but we are required to have you sign this consent form, just in case you do need a transfusion and are not awake at the time to give your consent. ALL blood is stringently tested for HIV, hepatitis, and cytomegalovirus.)
● You have the opportunity to ask questions
● You will receive a small bottle of antibacterial soap
This process generally takes two to three hours.
You will be given instructions as to which medications you should stop taking to prepare for surgery.
On the night before your surgery, shower using half of the bottle of antibacterial soap. On the morning of the surgery, before you come to the hospital, shower using the rest of the soap.
Do not eat or drink after midnight the night before your surgery. You may take your medications that the nurse practitioner approved you to take the morning of surgery, with just a small sip of water.
Parking is available in front of the 68th Street circular entrance to the hospital. There are also several parking garages in the immediate area.
Parking is only validated on the day of your hospital discharge, not on the day of your pre-surgical appointment.
Please be sure to bring your:
● Insurance card(s)
● Pajamas, robe, and slippers
Generally try not to bring too much to the hospital, because you probably won't use a lot of these things and will just have to carry them home.
Please do not bring any jewelry or expensive electronics with you for the first hospital day. Your family and friends are welcome to bring those items once you are awake and in your room.
Please check in at Greenberg 3-West (Same-Day Surgery Unit), which is on the third floor of the Greenberg Pavilion, using the "G" elevators.
If you are the first case, please check in at 6 a.m. If you are the second case, please check in at 10 a.m.
During your surgery, your family and friends should wait in the Ronald O. Perelman Heart Institute Atrium. Please tell them to check in at the front desk so that they can be contacted when your surgeon calls.
If the Ronald O. Perelman Heart Institute Atrium is closed at the time of your surgery, your family and friends may wait in the smaller waiting area right outside the Cardiothoracic ICU (4-West).
There is also a café on the first floor of the hospital, directly opposite the information desk and down the hall from the front door on the left, which is open at all times. This café sells coffee, tea, and a variety of food.
Pain in and around the incision may last up to several weeks. It is also very common to experience numbness around the incisions as well.
You will be given specific instructions about how to best care for the incisions. It is important to keep the wounds clean; normal soap and water is best for this care.
You can resume driving six weeks after your operation. Your physician will evaluate if you are ready to fly at your follow up appointment.
You will likely feel tired for a few days after the operation. We recommend taking short naps and trying to stay awake during the day as long as possible so that you can rest fully at night.
Exercise: Continue to use the incentive spirometer (the blue "ball machine") for the first week or two after you get home, approximately four to five times each day. Two weeks after surgery, you should be doing enough physical activity to stop using the machine.
Try to walk for 20 minutes twice a day when you come home, and slowly increase the frequency and duration of your exercise. You will slowly increase your endurance and energy level.
Diet: For the first one to two months after surgery, eat as much as you can without regard to salt and fat intake. In general, anesthesia will decrease your appetite, so it is important to eat as much as you can during this time to help your body to heal.
If you were on a special diet (such as a low-carbohydrate, diabetic, or kidney diet), continue following this diet after you feel that your appetite has recovered. Your care team will work with you to help determine the best diet to optimize your health.
Please see Insurance Questions or call (212) 746-5161.