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Laparoscopic reoperation after failed antireflux surgery.

B Neuhauser¹, R A Hinder

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.

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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.

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