THE IVOR LEWIS PROCEDURE (first sugge... - Oesophageal & Gas...

Oesophageal & Gastric Cancer

6,174 members3,322 posts

THE IVOR LEWIS PROCEDURE (first suggested in 1946) - illustration taken from a medical text book on surgery.

gutlesswonder profile image
4 Replies

Above is a relatively simplified diagram of the principal stages of this operation.

The two major incisions are shown in A, as relates to a small to medium sized tumour in the middle to lower portion of the eosophagus. If the carcinoma involved the upper end of the eosophagus then there will probably be a third incision in the cervical area, that is on the left side of the neck. [I have had this three stage operation]

B. Indicates the area of a tumour.

C. & D. Illustrate a short pull-up and a long pull-up through the diaphragm, determined by how much of the oesophagus needed to be removed.

It is abundantly clear how the stomach itself is salvaged, cut up and fashioned into a tube to bridge the gap caused by removal of the eosophagus; approximately from navel to Adam's Apple in the worst case.

Note that the straight arrows pointing to an ellipse in C. & D. show that what had been the entry into the top of the normal stomach is now at the bottom of the reconstituted stomach tube.

Also observe how the exit bend out of the normal stomach down into the Duodenum has been straightened out by the pull-up - this impairs the natural action of the Pyloric Sphincter leading to early and late discharge (Dumping/Congestion/Pain/Pseudo-satiation etc)

Is it any wonder that our normal functions are mucked up? ( should that be an 'f' for an 'm' ?) 

Written by
gutlesswonder profile image
gutlesswonder
To view profiles and participate in discussions please or .
Read more about...
4 Replies
Aurora12 profile image
Aurora12

Hi Gutless Wonder. That's a brilliant informative post - very clear explanatory diagrams! Thanks.  

haward profile image
haward

David Bowrey took the Leicester Upper GI group through the op step by step last Wednesday. This was very interesting but I did feel a bit queasy and quite glad that I hadn't paid attention to the detail before the op......

I was anxious to find out how they managed to stuff my 750ml stomach into the thoracic cavity and he explained that the new tubular stomach isn't much wider than the old gone oesophagus.

As you say it isn't surprising that there are after effects. What is surprising is how varied these are

patchworker profile image
patchworker

Thanks Gutless, that's fascinating.

Janashlin profile image
Janashlin

Yes an F

Not what you're looking for?

You may also like...

Two weeks & counting.

Two weeks to the day after my stomach was removed along with the tumour at the Oesophagus junction....

Positive Thinking does make the journey easier My Story

In early May of 2010 I had first notice difficulty in swallowing, this persisted for a few weeks...

Dumping

I had the Ivor Lewis operation to take out my Oesophagus due to stage 2 cancer Tumour about 8 weeks...

My feeding tube

I had a feeding tube put into my stomach about 4 months ago to give my ulcer time to heal. I...

Bile leaking from PEG-J site causing severe burning to exterior skin around the site

Does anyone else have this issue? I had the PEG-J put in earlier this year and am feed solely...