Minimally Invasive Esophagectomy at UPMC
Recently, doctors in the United States are diagnosing more esophageal cancers.
Obesity and long-term irritation from gastroesophageal reflux disease (GERD) seem to be contributors to this increase in new cases.
What Is Minimally Invasive Esophagectomy (MIE)?
MIE is surgery to remove cancer in the esophagus.
Surgeons at the UPMC Esophageal and Lung Surgery Institute mainly use MIE surgery to treat esophageal cancer, along with chemotherapy and radiation.
We perform MIE robotically through small incisions.
Benefits of Minimally Invasive Esophagectomy
The ultimate goal of MIE is to help you get back to a normal lifestyle.
Compared to traditional open esophageal cancer surgery, using minimally invasive techniques — including robot-assisted surgery — greatly:
- Reduces the risk of complications.
- Lessens pain.
- Shortens hospital stays.
Minimally invasive techniques have made the procedure safer and provided patients with improved quality of life.
The expertise of the medical center performing MIE surgery makes a big difference in the patient experience.
UPMC surgeons are among the most experienced in the world, performing nearly 2,000 MIEs.
Preparing for Minimally Invasive Esophagectomy Surgery
Diagnostic tests and cancer treatment
To decide if MIE surgery is your best treatment option, you will need imaging tests and other diagnostic procedures. These tests tell us the size and location of your tumor.
Tumors related to:
- GERD tend to be lower, closer to where the esophagus meets the stomach.
- Smoking and drinking alcohol tend to be higher in the esophagus.
Both types of tumors may be eligible for MIE, but the number of incisions may vary based on the tumor's exact location.
Doctors treat esophageal cancer with multiple modalities.
You may have chemo or radiation before MIE to shrink the tumor. You may also need chemo or radiation after surgery.
At the UPMC Esophageal and Lung Surgery Institute, we'll work closely with you to develop the best treatment plan for your condition.
Before the minimally invasive esophagectomy procedure
Your surgical team will provide you with details on how to prepare for your surgery. You can contact us any time with questions about your minimally invasive esophagectomy.
Your doctor will give you a list of drugs to stop taking and a diet to follow.
- Three days before surgery, you will begin a full liquid diet. This means only eating foods like cream soups, milkshakes, and smoothies.
- The day before surgery, this changes to a clear liquid diet.
- The night before surgery, you will need to do a gentle bowel prep and avoid eating or drinking after midnight.
Minimally Invasive Esophagectomy Procedure: What to Expect
You will receive general anesthesia and sleep through the operation.
During MIE, your surgeon will:
- Make small, band-aid sized cuts in the chest, abdomen, and possibly neck.
- Insert a tiny camera and surgical tools through these cuts.
- Remove most of your esophagus and part of the stomach.
- Reconstruct your stomach connect it to the remaining part of the esophagus.
Performed using the robot, you will have the same incisions and a camera and tools inserted.
The surgeon will:
- Sit at a console with a video screen that provides excellent visibility.
- Control the surgical tools from the console to perform the procedure.
The robot allows the surgeon great precision. He or she is in control of every movement throughout the operation.
MIE surgery can last anywhere from 4 to 10 hours, with an average of 6 hours.
After the minimally invasive esophagectomy procedure
You will spend one night in the intensive care unit before moving into a room on the thoracic surgery floor for recovery. At first, you will have a feeding tube in place for nutrition while the esophagus heals.
You can expect a hospital stay of about six days.
During this time, you'll begin a regimented advancement of your diet. You'll start with liquids and slowly work your way back to eating solid foods.
A dietitian will provide guidance on advancing your diet, along with oversight from your surgical team.
We will watch you closely for complications. We care about your quality of life and helping you get back to the things you enjoy.
If you have a fever or any signs of complications, call one of us right away.
Within about three or four weeks, you can resume many activities that aren't physically demanding.
The care team is here for you the rest of your life, as we follow up with you through regular outpatient clinic visits.
But, you can contact us any time at the UPMC Esophageal and Lung Surgery Institute if you have questions or need something in between visits.