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Related Experiment Videos

Laparoscopic reoperative antireflux surgery.

Z T Awad1, P I Anderson, K Sato

  • 1Department of Surgery, Suite 3740, Creighton University School of Medicine, 601 N. 30th Street, Omaha, NE 68131, USA.

Surgical Endoscopy
|April 20, 2002
PubMed
Summary

Laparoscopic reoperation for failed antireflux surgery offers a feasible solution for gastroesophageal reflux disease recurrence. This minimally invasive approach shows acceptable preliminary outcomes for patients needing revision surgery.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Antireflux operations for gastroesophageal reflux disease (GERD) can fail, necessitating reoperation due to symptom recurrence or complications.
  • Laparoscopic reoperation is explored as a solution for patients with previously failed anti-reflux procedures.

Purpose of the Study:

  • To evaluate the feasibility and preliminary outcomes of laparoscopic reoperative antireflux procedures.
  • To analyze patient demographics, presenting symptoms, and surgical approaches in reoperative GERD surgery.

Main Methods:

  • A cohort of 37 patients undergoing laparoscopic reoperative antireflux procedures between 1995 and 2000 was analyzed.
  • Procedures included Nissen fundoplication (n=27) and Toupet fundoplication (n=9), with 86.5% completed laparoscopically.

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  • Patient data included age, weight, presenting symptoms (heartburn, respiratory reflux, chest pain, regurgitation, dysphagia), and timing of recurrence.

    • Main Results:

    • Intraoperative and postoperative complications occurred in 6 and 14 patients, respectively.
    • Fundoplication disruption was identified as the primary cause of initial surgery failure.
    • At a mean follow-up of 26.5 months, 65% of patients had excellent to good outcomes, 21.5% fair, and 13.5% poor.

    Conclusions:

    • Laparoscopic reoperative antireflux surgery is technically feasible for managing failed primary procedures.
    • The approach demonstrates acceptable preliminary results for patients experiencing recurrent GERD symptoms after initial surgery.