Atlas of Esophageal Surgery

Preface to the Second Edition
Preface to the First Edition
Contents
Contributors
1 History of Esophageal Surgery
	Abstract
	1.1 Benign Diseases
		1.1.1 Gastroesophageal Reflux Disease
		1.1.2 Achalasia
	1.2 Malignant Diseases
		1.2.1 Esophageal Cancer
	Acknowledgements
	Suggestion Reading
2 Radiologic Evaluation of Esophageal Diseases
	Abstract
	Suggested Reading
3 Diagnostic and Interventional Endoscopy
	Abstract
	3.1 Indications for Endoscopic Therapy
	3.2 Preoperative Workup
	3.3 Endoscopic Mucosal Resection
	3.4 Endoscopic Submucosal Dissection
	3.5 Radiofrequency Ablation
	3.6 Peroral Endoscopic Myotomy
	3.7 Care After Endoscopic Procedures
	3.8 Pitfalls of Endoscopic Procedures
	References
4 Esophageal Function Tests
	Abstract
	4.1 Introduction
	4.2 Manometry
		4.2.1 Indications
		4.2.2 Classifications of Esophageal Motility Disorders
			4.2.2.1 Achalasia
			4.2.2.2 Esophagogastric Junction Outflow Obstruction
			4.2.2.3 Absent Contractility
			4.2.2.4 Distal Esophageal Spasm
			4.2.2.5 Hypercontractile Esophagus
			4.2.2.6 Ineffective Esophageal Motility
	4.3 Esophageal Motility and GERD
	4.4 Ambulatory pH Monitoring
		4.4.1 Indications
		4.4.2 Interpretation
		4.4.3 Symptom-Reflux Association
	4.5 Conclusions
	References
5 Patient Positioning
	Abstract
	5.1 Patient Positioning for Laparoscopic Antireflux Surgery, Laparoscopic Heller Myotomy, and the Laparoscopic Part of Ivor Lewis Hybrid Esophagectomy
	5.2 Trocar Positions for Laparoscopic Antireflux Surgery and Laparoscopic Heller Myotomy
	5.3 Trocar Positions for the Laparoscopic Part of Ivor Lewis Hybrid Esophagectomy
	5.4 Patient Positioning for the Thoracic Part of Ivor Lewis Hybrid Esophagectomy
	Acknowledgements
	Suggested Reading
6 Operations for Gastroesophageal Reflux Disease
	Abstract
	6.1 Clinical History
	6.2 Laparoscopic Total Fundoplication (360°)
		6.2.1 Positioning of the Patient and Placement of Trocars
		6.2.2 Operative Procedure
			6.2.2.1 Step 1
			6.2.2.2 Step 2
			6.2.2.3 Step 3
			6.2.2.4 Step 4
			6.2.2.5 Step 5
			6.2.2.6 Step 6
			6.2.2.7 Step 7
	6.3 Laparoscopic Partial Posterior Fundoplication (220–280°)
		6.3.1 Step 7
	6.4 Laparoscopic Partial Anterior Fundoplication (180°)
		6.4.1 Step 8
	6.5 Postoperative Course
	Acknowledgements
	Suggested Reading
7 Paraesophageal Hernia
	Abstract
	7.1 Clinical History
	7.2 Operation
		7.2.1 Patient Position
		7.2.2 Surgical Procedure
	Bibliography
8 Laparoscopic Heller Myotomy and Dor Fundoplication
	Abstract
	8.1 Clinical History
	8.2 Operation
		8.2.1 Patient Position and Placement of Trocars
		8.2.2 Operative Procedure: Heller Myotomy and Dor Fundoplication
			8.2.2.1 Step 1: Division of the Gastrohepatic Ligament
			8.2.2.2 Step 2: Identify the Right Crus of the Diaphragm and Posterior Vagus Nerve
			8.2.2.3 Step 3: Divide the Peritoneum and Phrenoesophageal Membrane Above the Esophagus
			8.2.2.4 Step 4: Divide the Short Gastric Vessels
			8.2.2.5 Step 5: Perform Esophageal Dissection in the Mediastinum
			8.2.2.6 Step 6: Excise the Fat Pad and Expose the Esophageal Wall
			8.2.2.7 Step 7: Perform Esophageal Myotomy
			8.2.2.8 Step 8: Perform Dor Fundoplication
			8.2.2.9 Step 9: Perform Final Inspection of the Myotomy
	8.3 Postoperative Course
	Acknowledgements
	Suggested Reading
9 Peroral Endoscopic Myotomy (POEM)
	Abstract
	9.1 Clinical History
	9.2 Operation
		9.2.1 Patient Preparation and Operative Setup
		9.2.2 Operative Procedure
			9.2.2.1 Step 1: Initial Endoscopy and Post-induction EndoFLIP Measurement
			9.2.2.2 Step 2: Mucosotomy and Entry into the Submucosal Space
			9.2.2.3 Step 3: Creation of the Submucosal Tunnel and Post-Tunnel EndoFLIP Measurement
			9.2.2.4 Step 4: Myotomy and Post-myotomy EndoFLIP Measurement
			9.2.2.5 Step 5: Mucosotomy Closure
	9.3 Troubleshooting
	9.4 Postoperative Course
	Acknowledgements
	Suggested Reading
10 Zenker’s Diverticulum: From the Open to the Endoscopic Approach
	Abstract
	10.1 Introduction
	10.2 Workup
		10.2.1 Treatment Options
		10.2.2 Open Transcervical Approach
		10.2.3 Rigid Endoscopic Approach
		10.2.4 Zenker’s Peroral Endoscopic Myotomy (Z-POEM)
		10.2.5 Zenker’s Diverticulopexy
	Suggessted Reading
11 Laparoscopic Treatment of Epiphrenic Diverticulum
	Abstract
	11.1 Epidemiology
	11.2 Anatomy
	11.3 Pathophysiology
	11.4 History and Physical
	11.5 Diagnostic Studies
		11.5.1 Barium Esophagogram
		11.5.2 Esophagogastroduodenoscopy (EGD)
		11.5.3 Esophageal Manometry
	11.6 Operative Techniques
		11.6.1 Laparoscopic Approach: Pre-incision Preparation
		11.6.2 Ports and Instruments
		11.6.3 Mobilization of the Esophagus
		11.6.4 Exposing and Stapling Diverticulum
		11.6.5 Performing Myotomy
		11.6.6 Creation of Partial Fundoplication
		11.6.7 Checking for Stenosis and Leak Test
	11.7 Postoperative Management
	11.8 Outcomes
	11.9 Alternative Approach: D-POEM
	References
12 Laparoscopic Resection of Esophageal Leiomyoma
	Abstract
	12.1 Clinical History
	12.2 Operation
		12.2.1 Patient Positioning
		12.2.2 Ports and Instruments
		12.2.3 Operative Procedure
			12.2.3.1 Step 1: Division of the Gastrohepatic Ligament, Peritoneum, and Phrenoesophageal Membrane
			12.2.3.2 Step 2: Dissection of the Gastric Component
			12.2.3.3 Step 3: Dissection of the Esophageal Component
			12.2.3.4 Step 4: Construction of the Dor Fundoplication
	12.3 Postoperative Course
	Acknowledgements
	Suggested Reading
13 Roux-en-Y Gastric Bypass for GERD and Morbid Obesity
	Abstract
	13.1 Clinical History
	13.2 Operation
		13.2.1 Patient Positioning
		13.2.2 Pneumoperitoneum and Port Placement
		13.2.3 Operative Technique
			13.2.3.1 Creation of Gastric Pouch
			13.2.3.2 Division of Small Bowel
			13.2.3.3 Creation of Jejuno-Jejunostomy
			13.2.3.4 Creation of Gastro-Jejunostomy
			13.2.3.5 Intraoperative Endoscopy
			13.2.3.6 Final Inspection and Removal of Trocars
	13.3 Postoperative Care
	Suggested Reading
14 Ivor Lewis Esophagectomy
	Abstract
	14.1 Case Description
	14.2 Procedure
	14.3 Postoperative Course
	14.4 Pearls and Pitfalls
	Acknowledgements
	Suggested Reading
15 Hybrid Transthoracic Esophagectomy
	Abstract
	15.1 Clinical History
	15.2 Operation: Hybrid Transthoracic Esophagectomy
		15.2.1 Laparoscopic Component
		15.2.2 Transthoracic Component
	15.3 Postoperative Course
	15.4 Hybrid Esophagectomy
	Acknowledgements
	Suggested Readings
16 Minimally Invasive Esophagectomy
	Abstract
	16.1 Preoperative Work-Up
		16.1.1 History and Physical Exam
		16.1.2 Common Operative Indications for Esophagectomy
		16.1.3 Work-Up
		16.1.4 Preoperative Considerations
	16.2 Operation: Three-Hole Minimally Invasive Esophagectomy
	16.3 Operation: Minimally Invasive Ivor Lewis Esophagectomy
	16.4 Perioperative Care: The ERP for MIE
	16.5 Technical Pitfalls and Complications
		16.5.1 Bleeding
		16.5.2 Splenic Injury
		16.5.3 Airway Injury
		16.5.4 Nerve Injury
		16.5.5 Conduit Necrosis
		16.5.6 Other Postoperative Complications
	Suggested Reading