Dr. Arindam Ghosh Gastrointestinal surgeon in SGH DUBAI, UAE has a vast experience in esophageal surgery.
He has performed 400 plus gastroesophageal surgeries.
ESOPHAGEAL PROCEDURES we are doing routinely
Esophagocoloplasty;
Thoracoscopic Cardiomotomy;
Nissen's / Toupet's Open and Laparoscopic;
Leight-collis gastroplasty; Diverticulectomy,
Mckewon's/ Lewis - Tanner Esophagectomy 2 field lymphadenectomy etc.
Esophagus is a mystery. Diseases of esophagus requires great expertise to treat .it is positioned very near to very vital organs &practically in continuity as there is no serosa of esophagus. Strongest layer of esophagus is mucosa. Sub mucosa is fatty without any collagen. Esophagus moves always.
DISEASES AFFECTING ESOPHAGUS TREATED LAPAROSCOPICALLY WITH EXCELLENT RESULTS
1. ACID REFLUX
2. ACIDIC AND CAUSTIC BURNS.
3. CANCERS ESOPHAGUS.
4. EXPOSURE TO FOREIGN BODY WIT ITS CONSEQUENCES.
5. TRACHEO ESOPHAGEAL FISTULAS
6. STRICTURES.
CANCER OF ESOPHAGUS is aggressive produces difficulty in swallowing and presents clinically at late stage. Corner stone of treatment is surgery. Now a days laparoscopic /VATS ESOPHAGECTOMY is a standard of care. To perform this surgery surgeon requires special expertise and training.
We have performed esophagectomies with less then 5% mortality. Not much is known about the cause but smoking and spicy foods may be the risk factor.It is more prevalent in north India specially Punjab. As a central place Ludhiana attracts lot many patients.
Suicidal or accidental they are amenable to endoscopic dilatation and stenting. But the failure and the complications of these modalities like perforation and fistula are not uncommon. Surgery plays a major part to cure this melody in terms of colon transposition of the esophagus with excellent result. We have done largest number of colon transpositions in north India.
GERD-(gastroesophageal reflux disease)-due to reflux of stomach acid into esophagus.if persists for long it can lead to cancer esophagus of gastro esophageal junction.
PARAESOPHAGEAL HERNIAS
All the above procedures can be treated laproscopically with excellent results
TRACHEOESOPHAGEAL FISTULAS –causes are cancer, foreign body, corrosives and congenital. Initial and mainstay of treatment is putting an covered esophageal stent .If it fails to heal then surgical diversion of the esophagus is needed with colon or gastric transposition.
RECURRENT HIATAL HERNIAS,- stomach enters the chest due to defect in the diaphragm.it is treated by pulling down the stomach and repairing the diaphragmatic defect. Sometimes mesh is used to reinforce the approximation. This procedure can be done laparoscopically with excellent results.
ACHALASIA CARDIA (LAPAROSCOPIC HELLER CARDIOMYOTOMY).-it is a motility disorder of the esophagus. Lower esophageal sphincter fails to relax during swallowing and emptying the esophagus. Diagnosed by endoscopy manometry and barium swallow. This can be treated laparoscopically by releasing the lower esophageal sphincter with excellent resuls. Patient can walk back home the next day ,relieved from all symptoms.
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