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Related Experiment Videos

Laparoscopic Nissen fundoplication after failed endoscopic gastroplication.

Vic Velanovich1, Tamir Ben Menachem

  • 1Division of General Surgery, Henry Ford Hospital, Detroit, Michigan 48202-2689, USA. vvelanol@hfhs.org

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|December 10, 2002
PubMed
Summary

Laparoscopic fundoplication is a feasible treatment for patients experiencing recurrent gastroesophageal reflux disease (GERD) symptoms after endoscopic gastroplication. While effective for typical GERD symptoms, atypical symptoms may not improve, and some patients may experience persistent dysphagia.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Endoscopic gastroplication was developed to treat gastroesophageal reflux but long-term efficacy remains unproven.
  • Laparoscopic fundoplication is a standard surgical treatment for gastroesophageal reflux disease (GERD).

Purpose of the Study:

  • To evaluate the feasibility and outcomes of laparoscopic fundoplication following failed endoscopic gastroplication.
  • To assess symptom control and quality of life in patients undergoing revision surgery for GERD.

Main Methods:

  • Retrospective review of 10 patients who underwent laparoscopic fundoplication after endoscopic gastroplication.
  • Preoperative assessment included 24-hour pH monitoring and GERD Health-Related Quality of Life (HRQL) questionnaire.
  • Surgical outcomes and postoperative complications were analyzed.

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Main Results:

  • Laparoscopic surgery was successful in 9 out of 10 patients, with no esophageal scarring.
  • Patients with typical GERD symptoms showed significant improvement (median GERD-HRQL score decreased from 27 to 4).
  • Patients with atypical symptoms did not experience improvement, and 6 patients had prolonged dysphagia, with 2 requiring dilation.

Conclusions:

  • Laparoscopic fundoplication is a viable option for patients with failed endoscopic gastroplication.
  • Symptomatic relief for typical GERD is comparable to primary laparoscopic fundoplication.
  • Persistent dysphagia is a potential complication that requires monitoring and management.