Revisional surgery after failed laparoscopic anterior fundoplication

Surgical Endoscopy
A J M Watson, Z H Krukowski

Abstract

Partial fundoplication may have functional advantages over a circumferential wrap but the reconstruction is more complex. Revisional surgery for recurrent reflux may be more difficult because of the additional suturing involved in the original operation. We report experience with revisional surgery in a large cohort of patients who had undergone laparoscopic anterior fundoplication and hiatal repair. Between August 1993 and September 1999, 11 (3.5%) of 309 patients who had laparoscopic anterior fundoplication for uncomplicated gastroesophageal reflux disease required revisional surgery (1 open and 10 laparoscopic revisions). Data were retrieved from a prospective database supplemented by a postal questionnaire following the second operation. The operative findings were posterior hiatal disruption (n = 9), anterior paraesophageal hernia (n = 1), and inadequate initial esophageal mobilization (n = 1). There were no conversions to open surgery in the laparoscopic group. Ten (91%) of the respondents described the outcome of their repeat procedure as either good or excellent. All patients would recommend the repeat procedure to patients with similar symptoms. Revisional surgery after laparoscopic anterior fundoplication can be perfo...Continue Reading

Citations

Apr 7, 2009·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Edgar J B FurnéeHein G Gooszen
Feb 17, 2009·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Constantine T FrantzidesGeorgios D Ayiomamitis
Aug 22, 2012·JSLS : Journal of the Society of Laparoendoscopic Surgeons·S A Khan, L Stephens
May 26, 2006·Journal of Surgical Oncology·Ralf SteinertMarc-André Reymond

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