Esophagectomy - Vagal-sparing
Vagal-sparing esophagectomy removes the esophagus while preserving the vagal nerves. These nerves, called the vagal plexus, are located around the esophagus and, among other things, are responsible for the function of the stomach and the small bowel.
The nerves of the vagal plexus around the esophagus are show in the image below.
Following vagal-sparing esophagectomy, patients will have a better eating ability and fewer problems with symptoms, such as diarrhea, which may be present after other types of esophagectomy. In this procedure, an incision is made in the abdomen and the esophagus is removed but the vagus nerves are preserved. To restore swallowing, the stomach or the colon (large bowel) is then used to replace the esophagus and is connected to the small remaining part of the esophagus in the neck via a neck incision. If the stomach is used, to replace the esophagus the procedure is called a gastric pull-up. If the colon is used to replace the esophagus, the procedure is called colon interposition.
Schematic Presentation of Vagal Sparing Esophagectomy and Colon Interposition