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Technical controversies in fundoplication surgery.

Gail Darling1, Claude Deschamps

  • 1University of Toronto, Toronto General Hospital, 10EN-228, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. gail.darling@utoronto.ca

Thoracic Surgery Clinics
|August 18, 2005
PubMed
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Gastroesophageal reflux disease (GERD) affects over 50% of people, impacting quality of life. This article reviews surgical treatments like fundoplication for GERD and paraesophageal hernias, discussing various technical approaches.

Area of Science:

  • Gastroenterology and Surgical Innovation
  • Minimally Invasive Surgery Techniques

Background:

  • Gastroesophageal reflux disease (GERD) is highly prevalent, significantly diminishing patients' quality of life.
  • Surgical interventions, particularly fundoplication, are established treatments for GERD and paraesophageal hernias.

Purpose of the Study:

  • To review and discuss technical controversies in fundoplication surgery for GERD and paraesophageal hernias.
  • To provide insights into optimizing surgical management for these conditions.

Main Methods:

  • Review of current surgical literature and practices regarding fundoplication.
  • Discussion of open versus laparoscopic approaches.
  • Analysis of complete (360°) versus partial fundoplication techniques.

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Main Results:

  • Laparoscopic fundoplication is a common approach for GERD and paraesophageal hernias.
  • Key technical decisions include the extent of wrap (360° vs. partial), the need for gastroplasty, and the use of mesh for crural repair.

Conclusions:

  • The article addresses critical technical choices in fundoplication surgery.
  • Informed decision-making regarding surgical approach and technique is essential for successful GERD and hernia management.