Esophageal Robotic Surgery

At South Florida Baptist Hospital, the robotic surgery team specializes in several esophageal procedures that have proven to have life-changing results for patients. The procedures involve using miniaturized instruments and tiny incisions.  These minimally invasive procedures help decrease recovery times, enhance outcomes, and other offer many other benefits to the patient. Some of the conditions we treat include:

• Achalasia - difficulty swallowing
• GERD - gastroesophageal reflux disease causing severe heartburn
• Hiatal hernia - difficulty swallowing and heartburn when bending over or lying down

Achalasia

Achalasia is a fairly rare disorder of the esophagus that makes it difficult for an individual to swallow solid or liquid foods. It occurs when the esophageal sphincter muscle (located between the esophagus and the stomach) does not relax normally, making it hard for food to pass from the esophagus into the stomach. Patients often complain of chest pain and discomfort, usually experience regurgitation of undigested food, and face significant weight loss. The disease is progressive and generally gets worse over time.

The Treatment: Robotic-Assisted Esophageal Heller Myotomy

Because medications are not effective in treating achalasia, surgery is the best definitive way to improve the condition. The esophageal Heller myotomy, where the circular muscle of the lower esophagus is cut and divided, decreases the pressure on the lower esophageal sphincter muscle and makes it easier to swallow.

The robotic-assisted procedure for achalasia enables the muscles of the sphincter, located between the esophagus and stomach, to be cut making it easier for food to pass through. Compared to traditional, “open” surgery through a large incision in the abdomen or side of the chest, patients undergoing a minimally invasive, robotic-assisted myotomy usually experience a faster and easier recovery and much less pain. After the surgery, patients usually need only a day or two in the hospital and are then able to recover at home. Most patients are able to return to normal activity in two to three weeks instead of the six to eight weeks with standard open surgeries.

GERD and Hiatal Hernia

Gastroesophageal reflux disease, or GERD, affects many people. Rather than the lower esophageal sphincter closing after swallowing and preventing stomach acid from flowing back into the esophagus, it weakens or relaxes. This can result in severe heartburn. Sometimes, a hiatal hernia can cause this same condition, called reflux. A hiatal hernia occurs when a small part of the upper stomach extends through the diaphragm and can make it difficult to swallow, eat many foods, and sleep.

The Treatment: Medication or Nissan Fundoplication

Medications can sometimes help the reflux condition, but many people cannot withstand PPIs (Proton Pump Inhibitors) due to effects such as bone demineralization, colitis, and interactions with other medications. A robotic-assisted surgical procedure known as Nissen Fundoplication can correct the condition for 10 years or more in over 85 percent of patients. The surgeon wraps the top of the stomach around the lower esophagus to reinforce it. This helps prevent stomach acid from backing up into the esophagus and can be used to repair a Type I sliding hiatal hernia, too. The robotic camera system allows for unparalleled visualization of the stomach and esophagus during the procedure.

For more information about robotic-assisted surgery or a physician referral, please call (813) 644-6773.