Transthoracic Approach for Achalasia
INDICATIONS/CONTRAINDICATIONS The age distribution of patients with achalasia is a bell-shaped curve ranging from the very young to those of advanced age. The peak age for clinical presentation is 30…
Laparoscopic Paraesophageal Hernia Repair
Figure 11.1 Types of hiatal hernia. The various types of hiatal hernia (Types I to IV) are depicted. (A) Sliding hiatal hernia. (B) True paraesophageal hernia with herniation of only…
Laparoscopic Heller Myotomy and Fundoplication for Achalasia
INDICATIONS/CONTRAINDICATIONS Because none of the available treatments can correct the underlying disease in patients with achalasia, the foundation of therapy is palliative and centers on relieving esophageal outlet obstruction while…
Bougie and Balloon Dilation of Esophageal Strictures—Malignant and Benign
INDICATIONS/CONTRAINDICATIONS Esophageal dilation is indicated for the treatment of dysphagia caused by esophageal-obstructing pathologies and functional disorders (Table 35.2). Achalasia, malignant strictures, and postoperative anastomotic strictures constitute the most common…
Endoscopic Mucosal Resection
INDICATIONS/CONTRAINDICATIONS Endoscopic resection is a minimally invasive, organ-preserving technique to endoscopically remove premalignancy or early-stage cancer arising from the gastrointestinal epithelium as a mucosal–submucosal complex. Patients with no risk of…
Open Collis Gastroplasty
Figure 7.1 Original Collis illustrations from 1957. (From: Collis JL. An operation for hiatus hernia with short esophagus. Thorax. 1957;12(3):181–188, with permission). INDICATIONS/CONTRAINDICATIONS The absolute indication for performing a Collis…
Open Paraesophageal Hernia: Transthoracic Approach
INDICATIONS/CONTRAINDICATIONS The primary indication for the repair of a paraesophageal hernia is a symptomatic hernia. The most common symptoms are postprandial pain (59%), vomiting (31%), and dysphagia (30%), but may…
Left Thoracoabdominal Exposure for Esophagectomy and Complex Hiatus Pathology
INDICATIONS/CONTRAINDICATIONS If one simply abides by the basic tenants of cancer surgery—(1) optimal exposure of the cancer field, (2) complete resection that includes radial margins, (3) extensive locoregional lymphadenectomy for…
Colon Interposition
INDICATIONS/CONTRAINDICATIONS Colon interposition is performed most frequently when the stomach is not suitable or available for use as an esophageal substitute. Possible reasons include previous gastrectomy, tumor involvement of the…
Fundoplication: Open Transabdominal Approach
INDICATIONS Reconstruction of the esophagogastric junction (EGJ) that includes fundoplication is indicated in the treatment of (1) gastroesophageal reflux disease (GERD) and (2) symptomatic mechanical obstruction resulting from Type III…
