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Laparoscopic reoperative surgery after laparoscopic fundoplication: an initial experience
1Department of Surgery, Ochsner Clinic Foundation, 1514 Jefferson Highway, New Orleans, LA 70121, USA. wrichardson@ochsner.org
Current Surgery
|December 14, 2004
Summary
Redo fundoplication surgery can be effective for treating recurrent hiatal hernias and associated symptoms like dysphagia. However, outcomes are less favorable than primary surgery, with increased risks and complications.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Hernia Repair
Background:
- Primary fundoplication surgery generally yields excellent outcomes.
- This study investigates failure patterns and outcomes of redo fundoplication procedures.
Purpose of the Study:
- To analyze the indications, surgical techniques, and outcomes of redo laparoscopic fundoplication.
- To evaluate the effectiveness and complications associated with repeat fundoplication surgery.
Main Methods:
- Ten patients underwent redo laparoscopic fundoplication between 1999 and 2002.
- Indications included recurrent hiatal hernia, reflux, dysphagia, and bloating, with one patient undergoing a third attempt.
Main Results:
- Two cases (20%) required conversion to open surgery due to adhesions.
- Intraoperative complications occurred in 30% of patients.
- Postoperative follow-up revealed symptom relief in some patients, but also persistent or new symptoms like reflux, bloating, and dysphagia.
Conclusions:
- Hiatal hernia is the primary driver for redo fundoplication surgery.
- Laparoscopic redo surgery offers benefits for dysphagia and heartburn but has higher morbidity and lower success rates than primary procedures.