Name of the Procedure:

Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)

Summary

Esophagoscopy with balloon dilation is a procedure where a rigid endoscope is inserted through the mouth to visualize the esophagus and use a balloon to dilate areas that are narrowed. This helps to improve swallowing and alleviate other symptoms caused by esophageal strictures.

Purpose

The procedure is used to treat narrowing (strictures) of the esophagus, which can cause difficulty swallowing and discomfort. The goal is to widen the narrowed areas, improving the ability to swallow and reducing related symptoms.

Indications

• Difficulty swallowing (dysphagia)
• Esophageal strictures or narrowing from conditions such as gastroesophageal reflux disease (GERD)
• Esophagitis or inflammation that causes narrowing
• Scarring from previous surgeries or radiation therapy

Preparation

• Fasting: Patients are typically instructed to not eat or drink for several hours prior to the procedure.
• Medication Adjustments: Certain medications may need to be paused or adjusted. Patients should follow their doctor's instructions closely.
• Pre-Procedure Testing: Diagnostic tests such as barium swallow or esophageal manometry might be required to assess the severity and location of the stricture.

Procedure Description

1. Anesthesia/Sedation: Patients are usually given general anesthesia or deep sedation for comfort.
2. Insertion: A rigid endoscope is inserted through the mouth into the esophagus.
3. Visualization: The endoscope allows the doctor to visualize the esophagus.
4. Balloon Dilation: A deflated balloon is positioned at the narrowed area and then inflated to gently widen the esophagus.
5. Completion: The balloon is deflated and removed, along with the endoscope.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is usually performed in a hospital or outpatient surgical center.

Personnel

• Gastroenterologist or surgeon
• Anesthesiologist or nurse anesthetist
• Nurses and surgical technicians

Risks and Complications

• Common risks: Sore throat, minor bleeding, reaction to anesthesia.
• Rare risks: Esophageal perforation, significant bleeding, infection, adverse reaction to anesthesia.

Benefits

• Improved ability to swallow
• Relief from symptoms such as pain and discomfort associated with esophageal strictures
• Benefits may be noticed immediately or within a few days

Recovery

• Post-procedure observation until the effects of anesthesia wear off
• Instructions to avoid eating or drinking for a few hours post-procedure
• Gradually reintroducing foods, starting with liquids
• Follow-up appointments to monitor the esophagus and assess the effectiveness of the procedure
• Temporary dietary restrictions and avoiding strenuous activities for a few days

Alternatives

• Medications: Proton pump inhibitors or H2 blockers to reduce acid reflux
• Soft Diet: Adjusting diet to softer, easier-to-swallow foods
• Surgical Options: In severe cases, surgical interventions like esophageal stent placement
• Comparison: Medications and diet modifications offer less immediate relief but are non-invasive, whereas surgery can be more complex and involves longer recovery.

Patient Experience

During the procedure, patients will be under anesthesia and will not feel pain. Post-procedure, they may experience a sore throat and minor discomfort. Pain management typically includes mild pain relievers and throat lozenges. Most patients can return to normal activities within a few days, provided they follow their doctor's recovery instructions.