Foregut Surgery Program

at the Department of Surgery within the Center for Digestive Disease at Robert Wood Johnson University Hospital and Rutgers Robert Wood Johnson Medical School

Our Foregut Surgery Program specializes in diagnosing and treating conditions of the esophagus and stomach. Our skilled surgeons are committed to a deep understanding of the pathophysiology, diagnosis and treatment of foregut disease and have expertise in a broad range of therapeutic options individualized to the specific needs of each patient. Our team of skilled surgeons use the latest advancements in minimally invasive and robotic-assisted techniques to provide safe, comprehensive care. We are committed to delivering personalized treatment plans, ensuring the best possible outcomes in a compassionate and supportive environment.

Our Approach to Patient Care

A cornerstone of our diagnostic process is our state-of-the-art esophageal physiology lab in collaboration with gastrointestinal (GI) motility specialists. This lab offers advanced testing, such as high-resolution manometry, endoluminal functional lumen imaging prove (EndoFLIP) and pH studies (Bravo® wireless pH study and impedance-pH study), to accurately diagnose conditions like GERD, LPRD, achalasia, and esophageal motility disorders. By combining this detailed data with our surgical expertise, we construct effective, targeted treatment strategies for each patient.

Our program also operates on a collaborative, multidisciplinary model. We work closely with interventional gastroenterologists, gastroenterologists, thoracic surgeons, ear, nose and throat (ENT) specialists, surgical and medical oncologists and speech-language pathologists.

This integrated approach ensures you receive a comprehensive evaluation and a unified treatment plan that considers all aspects of your health. This seamless collaboration allows us to address the full spectrum of foregut issues, from diagnosis to post-operative care, all under one coordinated program.

Foregut Diseases We Treat

We primarily focus on benign foregut disease and provide comprehensive care for more complex conditions such as revision surgery and cancer resection in collaboration with other specialties. We offer treatment for a wide range of foregut conditions, including but not limited to:

• Gastroesophageal reflux disease (GERD): Chronic acid reflux leading to heartburn and other symptoms
• Laryngopharyngeal reflux dsease (LPRD): Chronic reflux leading to laryngeal symptoms such as cough and hoarseness
• Achalasia: A rare disorder that makes it difficult for food and liquid to pass into the stomach
• Esophageal motility disorders (Jackhammer Esophagus and Distal Esophageal Spasm): Conditions that affect the movement of food through the esophagus
• Difficulty swallowing in throat (Cricopharyngeal bar, Zenker’s diverticulum): Conditions that affect the movement of food through the mouth to the esophagus
• Paraesophageal hernia and sliding hiatal hernia: A condition where part of the stomach pushes up through the diaphragm, causing GERD
• Epiphrenic diverticulum: Outpouching on the esophagus causing difficulty swallowing, regurgitation and other symptoms
• Gastroparesis: Slow stomach emptying (idiopathic, diabetic, post-surgical, etc.) causing nausea, vomiting, bloating and abdominal pain
• Recurrent hiatal hernia/GERD after previous surgery: More complicated conditions requiring surgical revision
• Foregut issues after bariatric surgery: Recurrent/persistent foregut issues such as reflux symptoms and/or difficulty swallowing after bariatric surgery (sleeve gastrectomy and gastric bypass)
• Esophageal cancer & gastric cancer: In collaboration with thoracic surgery, surgical oncology, and medical oncology, we provide integrated care for these conditions.
• Barrett's esophagus: A complication of chronic GERD where the lining of the esophagus changes.

Foregut Surgical and Endoscopic Procedures We Provide

Our surgical team is highly skilled in a variety of advanced foregut procedures, including:

• Laparoscopic and robotic paraesophageal hernia repair/hiatal hernia repair: Minimally invasive surgery to repair paraesophageal (hiatal) hernia
• Laparoscopic and robotic fundoplication: Minimally invasive surgery to treat GERD by creating “one-way valve”
• Laparoscopic and robotic magnetic sphincter augmentation (LINX®): Implantation of a novel magnetic device to treat GERD
• Laparoscopic and robotic Heller myotomy: A procedure to treat achalasia by cutting the muscle at the junction between the esophagus and stomach
• Laparoscopic and robotic pyloroplasty: Minimally invasive surgery to treat slow stomach emptying
• Laparoscopic and orbotic esophagojejunostomy: A procedure to treat complicated GERD, especially post-bariatric GERD
• Laparoscopic and robotic revision surgery: Complicated conditions due to the previous hiatal hernia repair and fundoplication requiring highly skilled revision surgery
• Robotic esophagectomy: Surgical removal of part or all of the esophagus, often for the treatment of esophageal cancer, performed in collaboration with our thoracic surgery teams.
• Laparoscopic and robotic gastrectomy: Surgical removal of part or all of the stomach, used to treat conditions like gastric cancer, performed in collaboration with our oncology and thoracic surgery teams.
• Per-oral endoscopic myotomy (E-POEM, Z-POEM, G-POEM): A minimally invasive endoscopic procedure to treat achalasia (E-POEM), Zenker’s diverticulum (Z-POEM) and gastroparesis (G-POEM)
• Laparoscopic jejunostomy tube placement: A procedure to place a feeding tube into the small bowel
• Percutaneous endoscopic gastrostomy (PEG). An endoscopic procedure to place a feeding tube into the stomach
• Endoscopic dilation and Botox injection: An endoscopic procedure to treat difficulty swallowing or slow stomach emptying

Locations

210 Somerset Street
5th Floor
New Brunswick, NJ 08901

1980 Route 9 South
3rd Floor
Old Bridge, NJ 08857

For more information, call 732-235-7920