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Laparoscopic reoperation after failed antireflux surgery.
1Department of Surgery, Mayo Clinic, Jacksonville, FL 32224, USA.
Seminars in Laparoscopic Surgery
|January 29, 2002
Summary
Laparoscopic reoperation for failed anti-reflux surgery is challenging but feasible. While complications occur, this redo surgery offers good outcomes, especially for patients with prior open procedures.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Laparoscopic anti-reflux surgery is a safe and effective alternative to long-term medical therapy for GERD.
- However, complications and failures necessitate reoperation, posing significant surgical challenges.
Purpose of the Study:
- To evaluate the outcomes and challenges of laparoscopic reoperation in patients with failed anti-reflux procedures.
- To assess the feasibility and morbidity associated with redo anti-reflux surgery.
Main Methods:
- A retrospective analysis of 100 consecutive patients undergoing reoperation for failed anti-reflux surgery.
- Previous procedures included laparoscopic (52), laparotomy (39), and thoracotomy (9) approaches.
Main Results:
- 30% of patients experienced peri- or postoperative complications, including stomach perforation (14) and bleeding (6).
- Only 2 patients required reoperation due to missed complications.
- The overall conversion rate from laparoscopic to open surgery was 17%.
Conclusions:
- Laparoscopic reoperation for failed anti-reflux surgery is a complex procedure with associated morbidity.
- Surgeons require extensive laparoscopic expertise and the ability to perform open surgery.
- Laparoscopic redo surgery is feasible and yields good results, offering advantages over previous open procedures.