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Related Experiment Videos

Laparoscopic refundoplications after failed antireflux surgery.

R Pointner1, T Bammer, P Then

  • 1Department of surgery, A.ö. Krankenhaus der Stadtgemeinde Zell am See, Austria.

American Journal of Surgery
|February 12, 2000
PubMed
Summary

Laparoscopic refundoplication is a safe and effective redo surgery for failed antireflux procedures, significantly improving patient outcomes and quality of life. This minimally invasive approach offers excellent results regardless of the initial surgery type.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Antireflux procedures, both open and laparoscopic, have failure rates necessitating reoperation in 3-6% of cases.
  • Reoperation addresses complications like recurrent reflux, dysphagia, or combined symptoms following initial anti-reflux surgery.

Purpose of the Study:

  • To evaluate the operative experience, postoperative results, and patient-reported outcomes of laparoscopic refundoplication.
  • To assess the efficacy of laparoscopic redo surgery for failed antireflux procedures.

Main Methods:

  • A retrospective analysis of 30 patients (18 male, 12 female; mean age 56) who underwent laparoscopic redo surgery.
  • Patients had prior open (18) or laparoscopic (12) antireflux surgery, with indications including recurrent reflux and dysphagia.

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Main Results:

  • Twenty-eight procedures were completed laparoscopically (21 Nissen, 7 Toupet), with 2 conversions to open surgery.
  • Significant improvements were observed in lower esophageal sphincter pressure, decreased DeMeester Scores (24-hour pH monitoring), and enhanced quality of life index.
  • Postoperative complications were minimal, including one case of dysphagia and one of gas bloat.

Conclusions:

  • Laparoscopic refundoplication is a feasible and effective treatment option for patients with failed primary antireflux surgery.
  • Excellent postoperative results and improved quality of life are achievable, irrespective of the initial surgical approach (open or laparoscopic).