OESOPHAGEAL DISORDERS AND ROBOTIC PROCEDURES
Oesophageal disorders comprise a wide range of conditions affecting the oesophagus, the muscular tube that carries food from the mouth to the stomach. These disorders include gastroesophageal reflux disease (GERD), achalasia, hiatal hernia, oesophageal strictures, Barrett’s oesophagus, oesophageal diverticula, benign oesophageal tumours, and oesophageal cancer. These conditions can impair swallowing, cause reflux symptoms, and significantly affect a patient’s quality of life.
Robotic oesophagectomy and fundoplication are performed under general anaesthesia with the patient positioned appropriately to allow access to the chest and abdomen. Several small incisions are made for the placement of robotic ports, through which a high-definition three-dimensional camera and robotic instruments are introduced. After docking the robotic system, the operative field is carefully explored, and the oesophagus and surrounding structures are exposed. In Robotic Oesophagectomy, the diseased portion of the oesophagus is meticulously mobilised and resected along with the appropriate regional lymph nodes when indicated for malignancy. The stomach is then fashioned into a conduit and brought into the chest or neck, where it is joined to the remaining oesophagus to restore gastrointestinal continuity. In Robotic Fundoplication, performed primarily for gastroesophageal reflux disease (GERD) and hiatal hernia, the lower oesophagus is mobilised, the hiatal defect is repaired if present, and the upper part of the stomach (fundus) is wrapped around the lower oesophagus to reinforce the lower oesophageal sphincter and prevent reflux. Throughout both procedures, meticulous haemostasis is maintained, and the integrity of the reconstruction or fundoplication is assessed before completing the operation. The specimen, when applicable, is retrieved through a small protected incision, surgical drains may be placed as required, the robotic instruments are removed, and the port sites are closed, completing the procedure.