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Updated: Aug 5, 2026
Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
Multimedia article. Laparoscopic fundoplication in an infant
Insights
Laparoscopic fundoplication is a safe and effective surgical treatment for infants with gastroesophageal reflux, leading to a quick recovery and discharge. This minimally invasive approach offers advantages for pediatric patients requiring reflux correction.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastroenterology
Background:
- Laparoscopic fundoplication is increasingly preferred for infant gastroesophageal reflux due to reduced patient discomfort and shorter hospital stays.
- Potential benefits include earlier return to work for parents.
Purpose of the Study:
- To demonstrate the operative features of laparoscopic fundoplication in an infant with a life-threatening event secondary to gastroesophageal reflux.
- To highlight the use of specific surgical techniques and technology in pediatric laparoscopic surgery.
Main Methods:
- Video depicts laparoscopic fundoplication using a 5 mm umbilical cannula for insufflation and a 5 mm angled telescope.
- Instruments inserted via stab incisions without additional cannulas.
- Utilized AESOP, a voice-activated robotic camera holder, for enhanced surgical visualization.
Main Results:
- The procedure involved dividing short gastric vessels, closing the crura, and securing the esophagus intra-abdominally.
- Ensured fundoplication wrap length of approximately 2.0 cm to prevent postoperative migration.
- The operative technique was straightforward.
Conclusions:
- The patient experienced an uneventful recovery and was discharged the day after surgery.
- No postoperative complications were observed.
- Laparoscopic fundoplication is a viable and safe option for infants with severe gastroesophageal reflux.
Background:
Laparoscopic fundoplication in infants and children is rapidly becoming the procedure of choice for surgical correction of symptomatic gastroesophageal reflux because of the advantages of reduced discomfort and decreased hospitalization. In addition, there may be a hidden benefit of an earlier return to work by the parents.
Methods:
This video depicts the salient operative features for performing a laparoscopic fundoplication in an infant who presented with an acute life-threatening event, which was felt secondary to gastroesophageal reflux. In this operation, a 5 mm cannula was placed in the umbilicus through which insufflation was achieved and a 5 mm, 45 degrees angled telescope was inserted into the peritoneal cavity. The four instruments were placed directly through the abdominal wall using a stab incision technique rather than using cannulas. Moreover, the operation was performed using AESOP, the voice-activated telescopic holder, which provides a steady and consistent view.
Results:
The operative technique was straightforward in that the short gastric vessels were divided, the crura were closed, and the esophagus was secured to the crura to keep the esophagus in an intraabdominal position and to prevent transmigration of the fundoplication wrap in the postoperative period. The length of the fundoplication should be around 2.0 cm and was measured to ensure that the fundoplication approximates this length.
Conclusion:
This patient made an eventful recovery and was discharged the following day. No complications have developed. [The full text of this article is a video computer file.]
