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Overview
What is Oesophageal Cancer?
Oesophageal cancer is a type of cancer that occurs in your oesophagus (your food pipe). It can start anywhere along the food pipe and the uncontrolled growth of cells happens along the inner walls of the pipe and can slowly spread outwards.
What are its Causes?
Oesophageal cancer develops due to changes in the DNA of the cells in the oesophagus. This can develop either on its own or due to damage caused by medical conditions or habits listed below.
Factors That Can Increase the Risk of Oesophageal Cancer
- Long-term acid reflux causing changes in the food pipe
- Frequent burning sensation in the chest or throat (heartburn)
- Rare inherited conditions that make swallowing difficult
- Previous history of head and neck cancer
- Viral infection of the mouth
- Obese/overweight
- Long history of alcohol drinking or smoking
- Being around certain chemicals for a long time
Symptoms of Oesophageal Cancer
- Burning sensation in the chest
- Unintentional weight loss
- Chest pain
- Long-term cough
- Hoarse voice
- Vomiting or coughing up blood
- Pain in your throat, back, chest or between your shoulder blades
How is it Diagnosed?
- X-ray test where you drink a special liquid that helps show the food pipe on scans
- Inserting a thin tube with a camera to look at your food pipe
- Taking a small sample of the food pipe tissue and analysing it
How is this Condition Treated?
- Chemotherapy
- Radiation therapy
- Combined treatments
- Surgery (removal of a part of or most of your food pipe, known as oesophagectomy)
Robotic Esophagectomy
What is it?
An esophagectomy is a surgery to remove all or part of your oesophagus, done using the help of a robotic system.
Why is this Procedure Done?
This procedure is commonly done to treat oesophageal cancer or any conditions that might be preventing your oesophagus from working properly.
Advantages of Robotic Surgery over Laparoscopic and Traditional Open Surgery
- Lower amount of blood loss
- Lower risk of health problems after surgery
- Shorter length of hospital stay
- Better removal of tumour
Procedure Details
Instructions Before the Procedure
- Doctors thoroughly review your medical history and do some tests to check the location of the tumour and severity of the condition
- You will be asked to fast for several hours before surgery; you might even be put on a liquid diet for a few days before the surgery
- If the tumour is big, you might be given a few rounds of chemotherapy or radiation therapy before the surgery
Step-by-Step Overview
- Patient is given a pain-killer and put to sleep
- Multiple small cuts are made around your chest through which a camera and the robot's arms are inserted
- The surgeon navigates the area and locates the affected portion of the oesophagus
- The surgeon then removes the affected portion or a large part of the oesophagus and then reconnects the remaining parts
- Temporary tubes for feeding and drainage are placed at appropriate locations
Risks & Complications
Common Risks
- Voice hoarseness
- Difficulty swallowing
- Leakage at the site where the connection between the oesophagus and stomach is made
- Pain and redness at the site of surgery
- Infection
Serious Complications
- Pneumonia
- Bad reaction to anaesthesia
- Blood clot
Benefits and Outcomes
Expected Results
- Removes the cancer from the food pipe
- Helps improve chances of survival
- Can relieve difficulty in swallowing
- Helps prevent the cancer from spreading
Hospital Stay & Recovery
After the Procedure
- You will be kept under observation, possibly overnight
- You are fed through a tube for 1–2 days
Hospital Stay Duration
- Feeding tube is removed
- Discharge after 6–8 days
Recovery Timeline
Full recovery can take up to a year or two.
Activity Restrictions
- Will only be able to exercise after a few days
- You will be advised to take short walks to prevent blood clots
- Do not exert yourself too much
Lifestyle & Prevention
Diet
- Will be initially fed through a tube for the first 2 months after the surgery
- You will slowly move to a liquid diet after the tube is removed; and after this, a solid diet if your progress is good
- Have small, frequent, and nutritious meals throughout the day
Exercise
- Only do light exercises once you feel you are up to it or as per the doctor's advice
Long-Term Care
- Attend all scheduled follow-up appointments to monitor healing and address any concerns
When to Contact a Doctor
- Have worsening pain or fevers
- Notice warmth or redness around the incisions
- You are feeling weak
- Shortness of breath / feel your heart racing
- Have diarrhoea or black stools
- Feel burning in your throat
- Have a cough that doesn't go away
- Develop jaundice (yellowing of the whites of the eyes or the skin)
- Have trouble swallowing
- Can't stop losing weight
Go to the emergency services immediately if you:
- Can't swallow or breathe
- Are vomiting blood
- Have severe pain, including chest pain
Myths vs Facts
Robotic esophagectomy is less complete than open surgery for cancer removal.
It allows precise removal of the tumour and surrounding tissue, similar to open surgery outcomes.
Robotic esophagectomy is not suitable for oesophageal cancer near the chest.
It is specifically helpful because it allows better access and precision in the chest area.
Robotic esophagectomy is only chosen for younger or very fit patients.
It can be considered for a range of patients, depending on overall health and cancer stage.
Frequently Asked Questions
Do I need to follow a special diet after my esophagectomy?
During your recovery, the goal is to get you back to eating both for pleasure and for nourishment. Normally, your stomach is a passage organ. After your esophagus is removed and rebuilt with your stomach or colon, you are advised to eat seven smaller meals each day. This is because if you eat a lot, you will feel full much more quickly. You can still enjoy many of the foods you love; you'll just have to eat smaller meals, more frequently than the standard three large meals each day.
When can I return to work?
Generally, your feeding tube will stay in place for 6–8 weeks. However, things like needing cancer medicines after surgery can change how long you need it. About 3 weeks after surgery, you'll have a swallow test. If the inside has healed well, you can start eating again. Once you're cleared to swallow, you'll slowly move your diet over about 10 days through clear liquids, full liquids, and soft foods.
Will I need a feeding tube before my esophagectomy?
If you are malnourished because your symptoms make it impossible for you to swallow, you will likely have a feeding tube placed before you undergo chemotherapy, radiation therapy or surgery.
References
- 1. Cleveland Clinic. Esophageal Cancer. Available from https://my.clevelandclinic.org/health/diseases/6137-esophageal-cancer
- 2. Mayo Clinic. Esophageal Cancer. Available from https://www.mayoclinic.org/diseases-conditions/esophageal-cancer/symptoms-causes/syc-20356084
- 3. Mayo Clinic. Esophageal Cancer: Diagnosis and treatment. Available from https://www.mayoclinic.org/diseases-conditions/esophageal-cancer/diagnosis-treatment/drc-20356090
- 4. Cleveland Clinic. Esophagectomy. Available from https://my.clevelandclinic.org/health/procedures/21054-esophagectomy
- 5. Coco D, Leanza S. Comparative outcomes of laparoscopic versus robotic esophagectomy: a systematic review and meta-analysis. Kardiochir Torakochirurgia Pol. 2025;22(3):199–205.
- 6. Witek TD, Brady JJ, Sarkaria IS. Technique of robotic esophagectomy. J Thor Dis. 2021;13(10):6195.
- 7. Max Healthcare. Robotic Surgery for Esophageal Cancer. Available from https://www.maxhealthcare.in/international/en/procedure/robotic-surgery-for-esophageal-cancer
- 8. Sarkaria IS, Rizk NP, Goldman DA, et al. Early quality of life outcomes after robotic-assisted minimally invasive and open esophagectomy. Ann Thorac Surg. 2019;108(3):920–8.
- 9. American Cancer Society. After Treatment for Esophageal Cancer. Available from https://www.cancer.org/cancer/types/esophagus-cancer/after-treatment.html
- 10. Penn Medicine. Esophagectomy. Available from https://www.pennmedicine.org/treatments/esophagectomy