Laparoscopic Toupet fundoplication for gastroesophageal reflux disease and hiatus hernia: proposal for standardization using the "critical view" concept

Updates in Surgery
Davide BonaLuigi Bonavina

Abstract

Laparoscopic Toupet fundoplication has gained progressive consideration in the management of patients with gastroesophageal reflux disease and hiatus hernia. Previous studies showed equivalent results in terms of reflux control with lower rate of side effects compared to the Nissen fundoplication. However, multiple technical variations may account for the long-lasting reputation of decreased durability and poor long-term reflux control. Inspired by the "critical view" concept, a step-by-step laparoscopic Toupet fundoplication is described and illustrated. During the study period, 2012-2017, 348 consecutive patients underwent laparoscopic Toupet fundoplication according to a standardized procedure. A large hiatus hernia was present in 39% of patients, and 14% had volvulus of the intrathoracic stomach. Sixty-four (18.4%) patients had one or more previously failed antireflux procedures. The median follow-up was 37 months (range 12-61). The Gastroesophageal Reflux Disease Health-Related Quality of Life score significantly improved compared to baseline (p < 0.001), and 77% of patients were off proton-pump inhibitors. The proposed standardization of the Toupet fundoplication based on a "critical-view" concept may help to improve repr...Continue Reading

References

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Jan 8, 2020·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Tommaso Panici TonucciLuigi Bonavina

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Citations

Apr 27, 2020·Hernia : the Journal of Hernias and Abdominal Wall Surgery·A AiolfiD Bona
Oct 6, 2020·Annals of the New York Academy of Sciences·Priya Sharma, Rena Yadlapati
Mar 28, 2021·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Stefano SiboniLuigi Bonavina
Oct 31, 2021·Hernia : the Journal of Hernias and Abdominal Wall Surgery·A AiolfiD Bona

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