Skepticism Gives Way to Remarkable Results for Surgical Procedure

Thirty years of experience with a complex surgical procedure called transhiatal esophagectomy has reduced mortality and complications and given the U-M Health System one of the best patient safety records with the procedure in the country.

Donald Rockefeller enjoys breakfast in his hospital room while visiting with Mark Orringer, who performed Rockefeller’s transhiatal esophagectomy surgery just five days earlier. Photo: Scott Galvin

First developed by Mark Orringer, M.D., now a professor and head of thoracic surgery, the operation is used to treat esophageal cancer and other conditions requiring removal of the esophagus. Since the U-M procedure does not involve opening the chest to remove the esophagus, it is less difficult for patients and generates fewer complications than a traditional thoracotomy.

Transhiatal esophagectomy was not warmly received by thoracic surgeons when Orringer first introduced it, but after 2,000 procedures, U-M’s mortality rate is now just 1 percent, and complication rates have dropped from 32 percent in the early years to between 1 percent and 2 percent more recently. “We have the most comprehensive experience with this operation ever reported,” Orringer says.

—Nicole Fawcett