The Spectrum of Surgical Remediation of Transoral Incisionless Fundoplication-Related Failures

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Ruchir PuriSteven P Bowers

Abstract

To evaluate outcomes of surgical remediation for symptomatic or anatomic failure after a transoral incisionless fundoplication (TIF). This retrospective study was performed on 11 patients who underwent a remedial operation following TIF failure between June 2011 and September 2016 at the Mayo Clinic in Florida for persistent foregut symptoms. Upper gastrointestinal workup characterized 1 patient as having normal post-TIF anatomy and 10 as having anatomic failure. Ambulatory pH testing was performed in 7 patients and was abnormal in all. All patients underwent a laparoscopic takedown of the prior endoscopic fundoplication and removal of all accessible polypropylene T-fasteners. All patients had esophageal salvage and have not required a reoperation. Anatomical findings included hiatal hernia (7), esophageal diverticulum (2), hiatal mesh erosion of esophagus (1), long-segment esophageal stricture (1), and normal anatomy (1). Remedial operations included laparoscopic explant of fasteners in all patients with conversion to fundoplication (7), resection/imbrication of esophageal diverticulum (2), Heller myotomy (1), and mesh explant and complex esophageal repair (1). Mean operative time was 177 minutes and median length of stay 3 da...Continue Reading

References

May 25, 2005·Annals of Surgery·C Daniel SmithJohn G Hunter
Jul 16, 2010·The British Journal of Surgery·E J B FurnéeI A M J Broeders
May 19, 2011·JAMA : the Journal of the American Medical Association·Jean-Paul GalmicheUNKNOWN LOTUS Trial Collaborators
Sep 13, 2012·Surgical Innovation·Vinciane MulsGuido Costamagna
Jan 8, 2013·Surgical Endoscopy·Bart P L WittemanNicole D Bouvy
Apr 13, 2013·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Kyle A PerryW Scott Melvin
Apr 13, 2013·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Adolf KaindlstorferRudolph Pointner
Feb 4, 2014·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Erik B WilsonKarim S Trad

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Methods Mentioned

BETA
motility study

Software Mentioned

Plicator

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