Successful esophageal surgery requires knowledge of the anatomy of the esophagus and mediastinum. The esophageal wall has two anatomically weak areas. Step-by-step technique for repair of pharyngoesophageal diverticulum, achalasia, and cardiospasm is detailed, along with transhiatal esophagectomy [including preparation of the gastric conduit (neoesophagus) and anastomosis].
Depending on presentation, surgical resection for carcinoma of the esophagus can be performed by Ivor Lewis, Ivor Lewis-McKeown (three-stage), or left thoracoabdominal esophagectomy. The colon may be harvested and used as an esophageal substitute in situations where the stomach is not usable.