Dr. Orringer popularized transhiatal esophagectomy in the 1980s as an alternative to the three incisions Ivor Lewis esophagectomy, involving a cervical, a thoracic, and an abdominal incision. The morbidity of the Ivor Lewis procedure was primarily due to pulmonary complications, and Dr. Orringer thought that the pulmonary complications could be lowered without the thoracic incision. The procedure was performed with an abdominal and a cervical incision and allowed mobilization of the stomach as a conduit to the cervical esophagus. A single anastomosis was made in the neck. If there was an anastomotic leak, the morbidity of this leak was far less than a devastating intrathoracic leak with the Ivor Lewis esophagectomy.
The procedure is still used today in patients requiring esophagectomy; however, it is not without its complications. The transhiatal esophagectomy procedure requires a skilled surgeon and a trained interprofessional team that works together to provide quality patient outcomes.
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