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Outcome of laparoscopic redo fundoplication
S Dutta1, F Bamehriz, T Boghossian
1Centre for Minimal Access Surgery, McMaster University, Hamilton, Ontario, Canada.
Surgical Endoscopy
|January 31, 2004
Summary
Laparoscopic redo fundoplication is a safe and effective treatment for recurrent gastroesophageal reflux disease (GERD) and hernias. This minimally invasive approach significantly reduces symptoms and improves outcomes with low complication rates.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Lack of objective evidence for laparoscopic redo fundoplication effectiveness.
- Need to evaluate outcomes using objective parameters.
Purpose of the Study:
- To assess the technical feasibility and clinical effectiveness of laparoscopic redo fundoplication.
- To analyze outcomes based on objective parameters in patients with recurrent GERD or hiatal hernias.
Main Methods:
- Prospective follow-up of 28 patients undergoing laparoscopic redo fundoplication.
- Indications included recurrent GERD, wrap herniation, and paraesophageal hernia.
- Objective assessments included endoscopy, 24-h pH study, manometry, and symptom scores.
Main Results:
- Laparoscopic approach was successful in 26 of 28 patients; low conversion rate.
- Significant reduction in acid reflux (5.01% to 0.48%) and symptom scores (28.96 to 10.75).
- Modest but significant increase in lower esophageal sphincter (LES) pressure.
Conclusions:
- Laparoscopic redo fundoplication is technically feasible and clinically effective.
- Demonstrates significant improvement in objective reflux parameters and symptoms.
- Low conversion and complication rates support its use in selected patients.