Dr A K Bansal provides the full spectrum of upper gastrointestinal surgery at Dr Bansal Gastro & Liver Centre, Gomti Nagar Extension and Myra City Hospital, Lucknow — including laparoscopic anti-reflux surgery (Nissen, Toupet), hiatal hernia repair, Heller's myotomy for achalasia, distal and total gastrectomy, surgery for peptic ulcer complications, and esophagectomy for esophageal cancer. Practice follows the SAGES, NCCN, ISDE, EAES and AGA guidelines.
Upper gastrointestinal surgery covers operations on the esophagus, stomach, duodenum and adjacent structures. The field includes functional surgery for severe GERD and achalasia, structural repair for hiatal hernia, oncological surgery for cancers of the esophagus and stomach, and surgery for benign conditions such as complicated peptic ulcer disease and gastric outlet obstruction.
Upper GI surgery is among the more demanding areas of gastrointestinal surgery because of the anatomical proximity to major vascular and respiratory structures, the technical complexity of reconstruction after resection, and the meticulous attention to nutrition, function and quality of life required after surgery. Modern care is multidisciplinary — combining surgical gastroenterology, medical gastroenterology, oncology, radiology and dietetics.
Dr A K Bansal offers the full range of contemporary upper GI surgery, with care delivered in line with guidelines from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), the National Comprehensive Cancer Network (NCCN), the International Society for Diseases of the Esophagus (ISDE), the European Association for Endoscopic Surgery (EAES), the American Gastroenterological Association (AGA) and the Indian Society of Gastroenterology.
The upper GI tract begins at the upper esophageal sphincter and extends through the esophagus, the gastro-esophageal junction, the stomach (cardia, fundus, body, antrum, pylorus) and into the duodenum. Key surgical landmarks include the diaphragmatic hiatus, the lower esophageal sphincter, the angle of His, the lesser and greater curvature of the stomach, and the pylorus.
Most patients with GERD respond well to lifestyle modification and proton pump inhibitor (PPI) therapy. Anti-reflux surgery is reserved for selected patients per SAGES, AGA and EAES guidance:
The most commonly performed anti-reflux operations are:
Pre-operative work-up routinely includes upper GI endoscopy, 24-hour pH-impedance monitoring and esophageal manometry to confirm diagnosis, exclude motility disorder, and inform the choice of wrap.
A hiatal hernia is a protrusion of part of the stomach (and sometimes other organs) through the diaphragmatic hiatus into the chest. Small sliding (Type I) hernias are extremely common and often asymptomatic — they may be managed medically along with GERD. Larger paraesophageal hernias (Types II–IV), giant hiatal hernias, and any hiatal hernia with intermittent obstruction or volvulus typically require surgical repair.
Laparoscopic hiatal hernia repair includes:
Achalasia is a primary esophageal motility disorder in which the lower esophageal sphincter (LES) fails to relax and the body of the esophagus loses normal peristalsis. Symptoms include progressive dysphagia for solids and liquids, regurgitation of undigested food, chest discomfort and weight loss. Diagnosis is confirmed by esophageal manometry (high-resolution manometry), barium swallow ("bird-beak" appearance) and upper GI endoscopy to exclude pseudoachalasia from malignancy.
Treatment options include:
Gastrectomy involves removal of part (partial/distal/proximal) or all (total) of the stomach. The most common indication is gastric cancer; other indications include large or complicated benign gastric tumours, GIST, refractory ulcer disease and selected gastric outlet obstruction.
For gastric cancer, oncological principles per NCCN and Japanese Gastric Cancer Association guidelines apply:
Esophagectomy is the surgical removal of part or all of the esophagus, typically for esophageal cancer (squamous cell carcinoma or adenocarcinoma) or selected benign disease (end-stage achalasia, caustic strictures). The procedure is complex and is performed in centres with appropriate volume, perioperative care and intensive care support. Common approaches:
Multidisciplinary care with medical and radiation oncology — including neoadjuvant chemoradiotherapy per CROSS / NCCN — is integral.
Modern medical therapy (PPI, H. pylori eradication) has dramatically reduced the need for elective ulcer surgery. Surgery is now mainly for ulcer complications:
Pre-operative work-up for upper GI surgery includes:
Risk profile varies sharply by procedure. General categories include:
Dr A K Bansal completed his M.Ch Surgical Gastroenterology at SGPGI Lucknow with All India Rank 1. He is Ex Senior Consultant in the Department of Gastrosciences at Medanta Hospital and currently heads the Department of GI Surgery at Myra City Hospital. His upper GI practice covers functional, benign and oncological disease.
Bring your endoscopy reports, biopsy results, prior imaging (CT, EUS, PET-CT) and current medications to your consultation.
Book AppointmentSurgery of the upper digestive tract — esophagus, stomach, duodenum — including anti-reflux surgery, hiatal hernia repair, Heller's myotomy, gastrectomy, esophagectomy and ulcer surgery.
For inadequately controlled GERD on optimal PPI, PPI intolerance, volume reflux, respiratory or ENT complications, large hiatal hernia, or patient preference after counselling. Pre-operative pH-impedance and manometry confirm suitability.
A protrusion of part of the stomach through the diaphragmatic hiatus into the chest. Small sliding hernias are managed medically; large paraesophageal or giant hernias usually need laparoscopic repair with cruroplasty and fundoplication.
Distal or total gastrectomy with adequate margins and formal D1+/D2 lymphadenectomy. Combined with peri-operative chemotherapy per NCCN. Early gastric cancers may sometimes be treated by endoscopic submucosal dissection.
Laparoscopic division of the LES muscle (6 cm + 2 cm) for achalasia, combined with a partial fundoplication (Dor or Toupet) to prevent reflux. POEM is an endoscopic alternative.
Laparoscopic Nissen / Heller / hiatal hernia: 1–2 days in hospital, 1–4 weeks to full activity. Gastrectomy: 5–10 days, 6–8 weeks recovery. Esophagectomy: 7–14 days, 8–12 weeks recovery.
Most modern elective upper GI procedures — anti-reflux, hiatal hernia repair, Heller's myotomy, distal gastrectomy and selected total gastrectomy — are routinely laparoscopic. MIE for esophagectomy is offered in experienced centres.