By P. Marco Fisichella, Marco G. Patti
This Atlas specializes in the outline of ways and surgical strategies used to regard the total spectrum of esophageal ailments. Surgical “pearls” and easy methods to decide upon and practice the proper operation are incorporated and dependent either on evidence-based facts and the adventure of the Editors.
Step-by-step descriptions of 14 operative systems in esophageal surgical procedure are supplied. each one bankruptcy describes the present symptoms, perioperative administration innovations, and an in depth operative method with appropriate technical issues.
The description of ways and surgical suggestions utilized in esophageal surgical procedure are defined in an simply comprehensible demeanour for the explicit audience.
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Borraez et al. Operative Procedure Step 1 Division of gastrohepatic ligament; identification of right crus of the diaphragm and posterior vagus nerve (Figs. 8) • The gastrohepatic ligament is divided, beginning above the caudate lobe of the liver, where the ligament is usually very thin, until the right crus of the diaphragm is identified. An accessory left hepatic artery originating from the left gastric artery is frequently present in the gastrohepatic ligament. If it limits the exposure, it may be divided with no clinical consequences.
Curr Opin Gastroenterol. 2010;26:453–8. 9. Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy. 2005;37:570–8. 10. Tomizawa Y, Waxman I. Enhanced mucosal imaging and the esophagus—ready for prime time? Curr Gastroenterol Rep. 2014;16: 389–96. 11. Wani S, Das A, Rastogi A, Drahos J, Ricker W, Parsons R, et al. Endoscopic ultrasonography in esophageal cancer leads to improved survival rates: results from a population-based study.
Ablation is repeated until the entire length of disease has received radiofrequency energy (Fig. 15). After the entire lesion is ablated, the guidewire, ablation catheter, and endoscope are removed. For focal ablation, the electric current is delivered through an electrode array attached to the end of the endoscope. The electrode is brought into close contact with the mucosal lesion, and the electric current is delivered through an electrode array attached to the end of the endoscope. Fig. 6 Peroral Endoscopic Myotomy Because it is time-consuming and complex, the POEM procedure requires general anesthesia.