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Cutting-Edge Digestive Care

Physicians at the Esophageal Center Offer Innovative Minimally Invasive Treatments

Michel Kahaleh, MDIn 2018, Robert Wood Johnson University Hospital (RWJUH) created The Esophageal Center to diagnose and treat patients with a variety of complex esophageal disorders. The physicians use novel, minimally invasive therapies. When necessary, they partner with specialists at Rutgers Cancer Institute of New Jersey, the state’s only National Cancer Institute-designated Comprehensive Cancer Center, to ensure the best outcomes. The Center is co-led by Michel Kahaleh, MD, Medical Director, Clinical Director of Gastroenterology and Chief of Endoscopy at RWJUH and Medical Director of the Advanced Endoscopy Research Program at Rutgers Robert Wood Johnson Medical School, and Susannah S. Wise, MD, FACS, Surgical Director. They explain how patients benefit from the Center.

What conditions are commonly treated at The Esophageal Center?

We often treat achalasia, a disorder in which a person has trouble swallowing food and liquid as a result of poorly functioning nerves in the esophagus. This can be done via an endoscope — a long, thin, flexible tube — in a procedure called Per Oral Endoscopic Myotomy (POEM). It can also be performed laparoscopically (using small incisions) through a procedure called Heller myotomy.

Susannah Wise, MD, FACSWe also see patients with refractory reflux, in which a person taking acid-reducing medications doesn’t experience complete relief from symptoms. Other conditions we treat include dysphagia (difficulty swallowing), esophageal spasm, Barrett’s esophagus, esophageal cancer, gastroesophageal reflux disease (GERD), Zenker’s diverticulum, hiatal hernia and esophageal perforation. Our team determines the best option for each patient (endoscopy or minimally invasive surgery) after a thorough evaluation.

What is unique about the Center?

Patients are cared for by a multidisciplinary team—gastroenterologists, thoracic surgeons, radiologists, radiation oncologists, surgical oncologists, medical oncologists and nutritionists. This is convenient because patients receive all the care they need in one location. Patients also benefit from the Center’s support groups.

What kinds of procedures are performed?

For years, physicians have used endoscopy — in which they look inside the body using a tiny camera attached to an endoscope — to diagnose patients with conditions such as GERD, in which stomach acid centers the esophagus chronically and irritates it. Now, endoscopy is being used at the center to perform a variety of procedures, causing less pain and bleeding and leading to a faster recovery. For instance, physicians can treat patients for conditions like Barrett’s esophagus, a precancerous condition in which there are abnormal changes in cells lining the esophagus due to GERD.

Patients with refractory reflux may benefit from transoral incisionless fundoplication, in which the top of the stomach is wrapped around the esophagus to create a valve that prevents acid from rising into the organ. Many patients who have this procedure are able to stop taking their acid-reducing medications.

Another minimally invasive procedure performed at the Center is POEM. This is effective for patients with swallowing disorders, including achalasia, which are often due to tightening of the muscles of the esophagus. The procedure involves opening the muscles endoscopically to ease digestion.

What role does Rutgers Cancer Institute of New Jersey play in caring for Center patients?

If a patient is diagnosed with a precancerous lesion or cancer of the esophagus, he or she is referred to Rutgers Cancer Institute of New Jersey. Through our partnership, patients have access to the most advanced treatment options, including clinical trials, immunotherapy, precision medicine, complex surgical techniques and innovative radiation therapy procedures.

To learn more about esophageal care at RWJUH, click here.