Comprehensive oesophageal surgical care — laparoscopic Heller myotomy for achalasia, anti-reflux surgery for GERD, hiatal hernia repair, oesophageal stricture management, and oesophagectomy — by Dr. Hamikchandra Patel at Shaleen Multi Speciality Hospital, Sola.
Understanding Oesophageal Disease
The oesophagus — a muscular tube approximately 25cm long — transports food and liquid from the mouth to the stomach. Oesophageal disorders range from functional problems (achalasia, GERD) to structural conditions (strictures, diverticula) and malignant disease (oesophageal cancer). Many oesophageal conditions cause swallowing difficulty (dysphagia), heartburn, regurgitation, or chest pain that significantly impairs quality of life.
Surgical intervention is required when oesophageal conditions do not respond to medications or endoscopic treatment, when there is malignancy, or when complications such as Barrett's oesophagus, stricture, or severe reflux disease require definitive repair. Dr. Hamikchandra Patel specialises in minimally invasive oesophageal surgery — prioritising laparoscopic approaches that minimise pain, reduce hospital stay, and accelerate recovery.
If you experience difficulty swallowing, persistent heartburn that does not respond to medications, regurgitation of food, unexplained chest pain, or weight loss — a specialist evaluation is essential.
Dysphagia (difficulty swallowing — solids first, then liquids), progressive weight loss, regurgitation of undigested food, chest pain not related to the heart, chronic heartburn unresponsive to PPIs, hoarseness or chronic cough, and vomiting of blood (haematemesis).
Upper GI endoscopy is the cornerstone of oesophageal diagnosis — providing direct visualisation of the oesophageal lining, identifying strictures, tumours, Barrett's changes, and oesophagitis. Biopsy and oesophageal manometry further define the condition and guide treatment planning.
The majority of oesophageal surgical conditions — hiatal hernia, achalasia, GERD, Zenker's diverticulum — can be addressed laparoscopically, avoiding large chest or abdominal incisions and enabling rapid recovery.
Oesophageal Conditions We Treat
Dr. Hamikchandra Patel provides expert surgical management for the full range of oesophageal conditions — from common to complex.
A motility disorder where the lower oesophageal sphincter fails to relax during swallowing, causing progressive dysphagia. Treated with laparoscopic Heller myotomy — incising the sphincter muscle to restore swallowing — combined with a partial fundoplication to prevent GERD.
When the stomach herniates through the diaphragm into the chest (hiatal hernia), it contributes to gastroesophageal reflux (GERD) — stomach acid damaging the oesophageal lining. Laparoscopic fundoplication and hiatal hernia repair restore the anatomical anti-reflux barrier permanently.
Narrowing of the oesophagus from chronic GERD-related scarring, caustic ingestion, or post-radiation. Endoscopic dilatation provides relief; recurrent or refractory strictures may require surgical correction or oesophageal replacement.
Squamous cell carcinoma (mid-oesophagus) and adenocarcinoma (lower oesophagus, associated with Barrett's) are the two main types. Oesophagectomy — resection of the oesophagus with gastric pull-up or colonic interposition — is the primary surgical treatment for resectable cancers.
Treatment Procedures
Laparoscopic division of the lower oesophageal sphincter muscle for achalasia. Combined with partial fundoplication to prevent post-operative GERD. Highly effective — over 90% of patients achieve lasting symptomatic relief. Same-day or 1-night hospital stay.
The upper stomach (fundus) is wrapped around the lower oesophagus to recreate and reinforce the anti-reflux barrier. Nissen (360°) or Toupet (270°) fundoplication depending on oesophageal motility. Definitive surgical cure for GERD and hiatal hernia.
Surgical resection of the oesophagus for cancer — performed via minimally invasive thoracoscopic-laparoscopic approach where feasible. The stomach is reconstructed as a neo-oesophagus (gastric pull-up). Multidisciplinary treatment including neoadjuvant therapy is coordinated with oncology.
Surgical Journey
Upper endoscopy (with biopsy if needed), oesophageal manometry, 24-hour pH monitoring, barium swallow, and CT scan provide a complete picture of the oesophageal condition and guide surgical planning.
Nutritional optimisation (especially for dysphagia patients), cardiac and lung function assessment, and multidisciplinary discussion for cancer cases. Specific dietary preparation as instructed for your procedure.
The planned procedure is performed under general anaesthesia — laparoscopic for most benign conditions; minimal invasive thoraco-laparoscopic for selected oesophagectomy cases. Intraoperative endoscopy assists in confirming completeness of the procedure.
Most patients begin with liquids and progress to soft and then normal foods over 2–4 weeks. Post-fundoplication dietary guidance includes avoiding carbonated drinks and large meals initially. Oesophagectomy patients follow a more structured dietary rehabilitation.
Follow-up endoscopy at 6–12 weeks confirms surgical success. For Barrett's oesophagus or cancer cases, regular surveillance endoscopy is scheduled. Long-term symptom assessment ensures durable surgical outcomes.
Patient Questions
Expert gastrointestinal and laparoscopic surgery at Shaleen Multi Speciality Hospital, Sola, Ahmedabad. Transparent consultation, honest advice, and patient-centred care always.
