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Related Experiment Videos

Laparoscopic refundoplication in children.

D C van der Zee1, N M Bax, B M Ure

  • 1Department of Pediatric Surgery, KE 04.140.5 Wilhelmina Children's Hospital, University Medical Centre Utrecht, Post Office Box 85090, 3508 AB, Utrecht, The Netherlands.

Surgical Endoscopy
|January 10, 2001
PubMed
Summary
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Laparoscopic refundoplication in children, following a previous Thal procedure, is a feasible surgical option. This approach effectively resolves gastroesophageal reflux symptoms without increasing patient morbidity.

Area of Science:

  • Pediatric Surgery
  • Minimally Invasive Surgery

Background:

  • Gastroesophageal fundoplication is a common pediatric surgery, with laparoscopic approaches significantly increasing its prevalence.
  • Laparoscopic fundoplication, despite its minimally invasive nature, is associated with substantial morbidity.
  • This study evaluates the outcomes of laparoscopic refundoplication in pediatric patients.

Observation:

  • Four children underwent laparoscopic refundoplication after a prior Thal procedure due to recurrent symptoms.
  • Two children had recurrent symptoms despite normal pH studies.
  • Surgical complexity varied, with one case requiring conversion and another complicated by a large hiatal hernia.

Findings:

  • Laparoscopic refundoplication involved converting the Thal procedure to Nissen or Toupet fundoplications in three children.

Related Experiment Videos

  • One child with an intrathoracic wrap and hiatal hernia underwent repair with a Goretex patch and redo-Thal.
  • All children were symptom-free from pathologic gastroesophageal reflux within 2 to 4 years of follow-up, with no recurrence.

    • Implications:

    • Laparoscopic refundoplication is a viable and safe option for managing recurrent gastroesophageal reflux in children previously treated with laparoscopic fundoplication.
    • This technique does not appear to increase the morbidity associated with initial antireflux surgery.
    • Further research may explore long-term outcomes and patient selection criteria for this procedure.