Esophagus Surgery in Surat What to Expect
Esophagus (food pipe) surgery covers operations for cancer of the esophagus, severe reflux and hiatus hernia, achalasia and other swallowing disorders. Most are performed laparoscopically or with the surgical robot by our foregut surgeons.
What is Esophagus Surgery?
The esophagus carries food from the throat to the stomach through the chest. Surgery on it is specialised because the organ lies deep in the chest and abdomen and its wall heals less readily than the bowel. The commonest operations are esophagectomy for cancer (removal of part of the esophagus and reconstruction using the stomach), anti-reflux surgery such as fundoplication with repair of a hiatus hernia, and Heller's myotomy for achalasia.
Our surgical gastroenterology team at Adajan includes a foregut surgeon with a special interest in esophageal and gastric disease. Wherever it is safe, the operation is done through keyhole incisions in the abdomen and chest, or robotically, which reduces pain and speeds recovery. Cancer surgery is planned jointly with the medical gastroenterologists and oncologists, and often follows chemotherapy or chemoradiotherapy.
At Gujarat Gastro & Vascular Hospital, surgery is never the first step. Reflux, achalasia and strictures are first assessed by the medical gastroenterology team on the same campus, with endoscopy, manometry and pH studies in the GI motility lab, and endoscopic treatments such as dilatation and POEM are offered where they suit. The operation is decided with you once the diagnosis is clear.
When is Esophagus Surgery Needed?
Your surgeon may recommend an operation for:
- Cancer of the esophagus or the junction with the stomach, when it can be removed completely See: cancers of the digestive system
- Severe acid reflux that does not respond to medicines, or reflux with a large hiatus hernia See: acidity and reflux (GERD) · hernia
- Achalasia - failure of the lower esophageal muscle to relax - when endoscopic treatment is unsuitable or has failed See: difficulty swallowing
- Esophageal perforation or injury
- Benign tumours and pouches (diverticula) of the esophagus causing symptoms
- Strictures that cannot be managed by endoscopic dilatation See: difficulty swallowing
Many esophageal problems are treated without an operation. Your gastroenterologist and surgeon decide together which route is right for you, and the reason is explained before consent.
Your Esophagus Surgery Stay: Step by Step
Esophagus surgery is a planned operation. Anti-reflux and achalasia surgery mean a short stay; esophagectomy for cancer is a major operation with a longer one. This is the usual path from assessment to follow-up.
- Assessment and decision
A full assessment is completed first: endoscopy with biopsies, CT and often PET scan and endoscopic ultrasound for cancer, or manometry and pH studies for reflux and achalasia. The surgeon then explains the operation, its risks and the alternatives, and you decide together.
- Fitness checks and preparation
Tests and a fitness assessment, including lung and heart function for esophagectomy. Nutrition support if swallowing has caused weight loss, stopping smoking and breathing exercises. Cancer patients may complete chemotherapy or chemoradiotherapy first, with surgery six to eight weeks later. You receive written fasting and medicine instructions.
- Admission
Admission at the main hospital in Adajan, fasting from the night before.
- The operation
Under general anaesthesia, usually through several small keyhole incisions in the abdomen and, for esophagectomy, the chest. For cancer the diseased segment and nearby lymph nodes are removed and the stomach is shaped into a tube; for reflux the hiatus hernia is repaired and a wrap is made; for achalasia the tight muscle is divided (described in the next section).
- Hospital stay and going home
Anti-reflux and achalasia surgery: home in one or two days. Esophagectomy: intensive care for a day or two, a hospital stay of seven to ten days, and tube feeding until the join has healed and a swallow test is clear. Follow-up is with the surgeon and, for cancer, the oncology team - at Adajan or at the OPD nearest you.
What Happens During Esophagus Surgery
A full assessment is completed first: endoscopy with biopsies, CT and often PET scan and endoscopic ultrasound for cancer, or manometry and pH studies for reflux and achalasia
The operation is performed under general anaesthesia, usually through several small keyhole incisions in the abdomen and, for esophagectomy, the chest
For cancer, the diseased segment and nearby lymph nodes are removed and the stomach is shaped into a tube and joined to the remaining esophagus in the chest or neck
For reflux, the hiatus hernia is repaired and the upper stomach is wrapped around the lower esophagus to strengthen the valve
For achalasia, the tight muscle at the lower end is divided and a partial wrap is added to prevent reflux
Drains and a feeding tube may be placed for esophagectomy; anti-reflux and achalasia operations usually need neither
What you will feel - and what you won't. You are under general anaesthesia for the whole operation and feel nothing. After anti-reflux or achalasia surgery there is soreness at the small wounds and sometimes a sense of bloating or a tight feeling when swallowing while swelling settles; both are eased with pain relief and a soft diet. After esophagectomy there is more discomfort in the chest and abdomen, which is controlled with regular pain relief so that you can breathe deeply and walk early; drains and a feeding tube feel strange rather than painful and are removed as recovery allows.
How to Prepare for Esophagus Surgery
- Tests and fitness. Tests and a fitness assessment, including lung and heart function for esophagectomy.
- Eating well before surgery. Nutrition support before surgery if swallowing has caused weight loss.
- Lungs and breathing. Stopping smoking and breathing exercises to reduce chest complications.
- Fasting and medicines. Fasting from the night before; your doctor will tell you which regular medicines to take. Please follow the written instructions exactly, especially for blood thinners and diabetes medicines.
- If you are having cancer treatment first. Cancer patients may complete chemotherapy or chemoradiotherapy first, with surgery six to eight weeks later.
These are general points. The written instructions you receive from the hospital for your own procedure take priority - see also Patient Information.
After Esophagus Surgery: Recovery & Eating Again
After anti-reflux or achalasia surgery. Anti-reflux and achalasia surgery: home in one or two days, soft diet for two to four weeks, back to work in about two weeks.
After esophagectomy. Esophagectomy: intensive care for a day or two, hospital stay of seven to ten days, feeding through a tube until the join has healed and a swallow test is clear. Smaller, more frequent meals for several months after esophagectomy while the stomach tube adapts.
Follow-up and getting back to normal. Follow-up with the surgeon and, for cancer, the oncology team. Gradual return to normal activity over four to eight weeks.
Is Esophagus Surgery Safe?
All esophageal surgery carries the general risks of anaesthesia, bleeding and infection. Anti-reflux surgery can cause temporary difficulty swallowing or bloating, which usually settles. Esophagectomy is a major operation: the main specific risks are a leak at the join, chest infection and heart-rhythm disturbance, which is why it is done only in fit patients after careful assessment and with intensive-care support.
Contact the hospital if you develop fever, chest pain, breathlessness, difficulty swallowing or wound discharge after you go home.
After a procedure, contact the hospital at once for severe pain, fever, vomiting, bleeding or breathlessness: Emergency 24×7: 90333 62020
Alternatives to Esophagus Surgery
Many esophageal problems are treated without surgery: medicines and lifestyle changes for reflux, endoscopic dilatation or POEM for achalasia and strictures, endoscopic removal (ESD) for the earliest cancers, and chemoradiotherapy alone for cancers that cannot be removed. Your surgeon and gastroenterologist will discuss which route is right for you.
Why Choose Gujarat Hospital for Esophagus Surgery
Esophagus surgery needs a surgeon who does this work, a gastroenterology team to assess you first and intensive care behind the operation. At Gujarat Gastro & Vascular Hospital, Adajan, Surat:
- A consultant foregut surgeon. Dr. Meet Desai, Consultant GI & Foregut Surgeon (DrNB Surgical Gastroenterology, FMAS), performs oesophageal and gastric surgery, laparoscopic and open, alongside Dr. Naresh Gabani, Consultant Surgical Gastroenterologist & GI Robotic Surgeon.
- Keyhole and robotic approaches. Wherever it is safe the operation is done through small incisions in the abdomen and chest, or with the robotic surgery system in suitable patients, which reduces pain and speeds recovery. Open surgery is used where that is safer.
- Swallowing assessed by the medical team first. The medical gastroenterology team on the same campus does endoscopy, manometry and pH studies in the GI motility lab, and offers dilatation, POEM for achalasia and ESD for the earliest cancers - so you are only offered an operation when it is the right treatment.
- Intensive care for esophagectomy. The 9-bed ICU with ventilator support on the same campus looks after you for the first day or two after esophagectomy, with an on-site laboratory and blood bank by referral.
Frequently Asked Questions about Esophagus Surgery
Is esophageal cancer surgery done by keyhole?
Yes, whenever the tumour and the patient's condition allow. Minimally invasive and robotic esophagectomy reduce chest complications and pain compared with open surgery.
Do I need an operation for my reflux?
Usually not. Most reflux is controlled with medicines and lifestyle changes, and surgery is considered only when severe reflux does not respond to medicines or there is a large hiatus hernia. Manometry and pH studies in the GI motility lab are done first to confirm that an operation is the right treatment. Your gastroenterologist and surgeon decide together.
Will I be able to eat normally after anti-reflux surgery?
Yes. There is a period of soft food while swelling settles, and some people find fizzy drinks and very large meals uncomfortable, but a normal diet returns within weeks.
What is the difference between POEM and Heller's myotomy for achalasia?
Both divide the tight muscle at the lower end of the esophagus. POEM is done from inside with an endoscope, without any cuts on the skin, by the medical gastroenterology team. Heller's myotomy is a keyhole operation in which the muscle is divided from outside and a partial wrap is added to prevent reflux. Surgery is offered when endoscopic treatment is unsuitable or has failed.
How long is recovery after esophagectomy?
Most patients are home within ten days and back to light activity in four to six weeks, with eating patterns continuing to adjust for several months.
How will I eat in the months after esophagectomy?
The stomach tube that replaces the esophagus holds much less than a normal stomach, so meals become small and frequent - five or six a day - taken slowly and chewed well, with drinks between rather than with meals. Sleeping with the head of the bed raised reduces reflux at night. A dietitian guides you, and most people find their eating pattern settles over several months as the body adapts.
Why is there a feeding tube after esophagectomy?
The join between the stomach tube and the remaining esophagus needs time to heal before food passes over it. Until the join has healed and a swallow test is clear, you are fed through a tube so that you get full nutrition without putting the join at risk. Once eating restarts, meals are small and frequent for several months while the stomach tube adapts.
Can reflux come back after anti-reflux surgery?
The wrap can loosen or the hiatus hernia can recur over the years, particularly with heavy lifting, straining, weight gain or persistent coughing, so some patients notice reflux symptoms again. Many are managed with medicines alone; a small number need a repeat operation. Keeping to a healthy weight and avoiding straining in the early weeks helps the repair hold.
The information on this page is for general patient education and does not replace individual medical advice, diagnosis or treatment. Medical Disclaimer