Each of the following disease states is approached through a minimally invasive technique at UC Irvine.

• Esophagus Cancer
Laparoscopic/Thoracoscopic esophagectomy: Minimally invasive esophagectomy is a technically demanding operation which affords patients the same benefits of other minimally invasive surgeries when compared to open esophagectomy. Only a handful of centers in the United States offer minimally invasive esophagectomy and UC Irvine has one of the largest published experiences using this technique. It involves abdominal mobilization of the stomach and thoracic resection of the esophagus with replacement by the stomach, which is brought up into the chest allowing for normal eating habits after the operation.

• Gastric Cancer
Laparoscopic gastrectomy: UC Irvine has one of the most extensive experiences in minimally invasive stomach surgery. This involves removal of part or all of the stomach and replacement with a limb of intestine to provide patients with the ability to eat in a normal fashion following surgery.

• Gastroesophageal reflux disease (GERD)
Laparoscopic Nissen fundoplication and endoscopic fundoplication: GERD is initially managed with medication. When medication is not sufficient, or when patients do not want to continue taking medications for GERD, then repair of the esophagus/stomach junction using either endoscopic (through the mouth without abdominal incisions) or laparoscopic wrapping of the stomach to terminate the symptoms associated with GERD can be performed. UC Irvine surgeons are among the most experienced in performing such procedures.

• Hiatal hernia
Laparoscopic hiatal hernia repair: Similar to operations for GERD, hiatal hernia repair involves tightening the hole in the diaphragm through which the esophagus passes on its way to the stomach. In addition, a stomach wrap (usually a 360 degree fundoplication) is performed to alleviate the symptoms of GERD that are associated with hiatal hernia.

• Achalasia
Laparoscopic Heller myotomy: Narrowing of the end of the esophagus due to overactive muscles leading into the stomach is sometimes ineffectively treated with medications or serial dilations. In this case a Heller myotomy is performed in which the thick muscle of the distal esophagus and proximal stomach is split, resulting in loosening of the esophagus/stomach junction and return of normal swallowing for the patient.