Foregut and Esophageal Surgery

If you have ongoing reflux, trouble swallowing, or another condition affecting your esophagus or stomach, our surgeons offer minimally invasive surgical options designed to help you feel better with less pain and faster recovery.
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Problems of the foregut — the upper gastrointestinal (GI) tract that includes the esophagus and stomach — can interfere with your ability to eat, sleep, and enjoy daily life. Medications don’t always relieve symptoms or fully address underlying conditions. Foregut and esophageal surgery can help when symptoms persist, complications develop, or your quality of life is affected.

At University of Iowa Health Care, our GI surgeons use minimally invasive and robotic‑assisted techniques whenever possible to treat a wide range of foregut conditions while also bringing specialized expertise to complex and revisional surgical cases. They also work collaboratively across specialties to design a personalized, comprehensive treatment plan that addresses the root cause of your symptoms and aligns with your specific needs.

Our approach to foregut and esophageal surgery

Your care starts with an advanced, patient-centered approach that focuses on treating your underlying condition. Your care is guided by a multidisciplinary team that includes specialists in gastroenterology, bariatric care, oncology, radiology, anesthesia, and nutrition. Together, they will develop a comprehensive, personalized care plan to meet your needs. Together, they will determine the most appropriate treatment for your condition.

Our surgeons have the specialized expertise and experience to deliver care across the full range of foregut conditions, including using minimally invasive or robotic-assisted techniques, whenever possible. These techniques often allow for smaller incisions, less pain, shorter hospital stays, and a faster recovery, while still providing strong, long‑lasting results.

They also have the advanced training to manage complex and revision cases, such as patients who have had prior anti‑reflux or bariatric procedures that didn’t fully resolve symptoms or led to new challenges.

Types of foregut and esophageal surgery

We offer a full range of foregut and esophageal surgeries, with techniques chosen based on your condition, symptoms, and prior treatments. Most procedures are performed using minimally invasive or robotic-assisted approaches whenever appropriate.

Surgery for acid reflux and hiatal hernia

These procedures help control reflux, protect the esophagus, and repair hernias where the stomach moves up to the chest.

  • Fundoplication surgery (Nissen, Toupet, or Dor), which strengthens the valve between the esophagus and stomach to reduce reflux
  • Hiatal hernia repair, including complex paraesophageal hernia repair when the stomach has moved into the chest
  • Revisional anti‑reflux or hernia surgery for patients whose prior surgery no longer works or caused new symptoms
  • Conversion to gastric bypass, in select patients with severe reflux after earlier anti‑reflux surgery

Surgery for swallowing disorders and esophageal conditions

These treatments help improve swallowing and address damage or structural problems of the esophagus.

  • Heller myotomy (often combined with partial fundoplication) to treat achalasia
  • Repair of esophageal perforations
  • Removal of benign esophageal tumors, such as leiomyoma
  • Surgical repair of large paraesophageal hernias involving the stomach in the chest

Surgery for stomach and upper intestinal conditions

These procedures treat noncancerous stomach and duodenal (the first part of the small intestine) conditions that can cause pain, bleeding, blockage, or emergency symptoms.

  • Partial gastrectomy for benign stomach disease
  • Removal of gastric submucosal tumors, including gastrointestinal stromal tumors (GIST)
  • Repair of perforated stomach or duodenal ulcers
  • Treatment of gastric volvulus, including gastropexy to prevent the stomach from twisting
  • Surgery for gastric outlet obstruction that blocks food from leaving the stomach 

What to expect from foregut and esophageal surgery

From your first visit through recovery, your care team will guide you through each step of the process, so you know what to expect and feel prepared.

Before surgery

You’ll start with a thorough evaluation to confirm your diagnosis and determine the best treatment plan. This may include imaging studies, endoscopy, and specialized esophageal testing. You may also meet with other specialists, such as gastroenterology or nutrition, depending on your needs. Your surgeon will review your results, explain your options, and answer questions so you can make informed decisions about your care.

Day of surgery

Most foregut and esophageal procedures are performed using minimally invasive or robotic techniques. These approaches use small incisions and advanced technology to support precision and safety. Your anesthesia team will be with you throughout the procedure, and your surgeon will talk with you and your support person after surgery to review next steps.

Hospital stay and recovery

Recovery time varies depending on the procedure, but many patients have shorter hospital stays with minimally invasive surgery. You’ll receive close monitoring, pain control, and guidance on activity, breathing exercises, and diet progression. Our team focuses on helping you get up and move, along with safe eating, as soon as it is appropriate.

Going home

Before discharge, you’ll receive clear instructions on medications, diet, activity, and follow‑up appointments. Your care team remains available to answer questions and support your recovery. Most patients are able to return to normal activities gradually over the weeks following surgery.

Who can benefit from foregut and esophageal surgery?

Upper GI and esophageal surgery may be right for you if ongoing symptoms are affecting your quality of life or haven’t improved with medicine or prior treatment. Our team treats both straightforward and complex conditions, including:

If you’ve been told your case is complex — or surgery may be difficult — our surgeons have deep experience in revisional and reoperative foregut surgery and work with a multidisciplinary team to plan care safely.

Not sure if surgery is right for you?

When you call 1-319-356-4901, we’ll help you find a provider who meets your needs.
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  • Christine Melichar, Support Services Specialist

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