[Intraoperative endoscopy in laparoscopic fundoplications]

Area of Science:

• Gastroenterology
• Surgical Innovation
• Medical Device Technology

Background:

• Laparoscopic fundoplication is standard for gastroesophageal reflux disorder.
• Adequate surgical technique is crucial for successful outcomes.
• A standardized method for evaluating the procedure is lacking.

Purpose of the Study:

• To evaluate the utility of intraoperative endoscopy in assessing laparoscopic fundoplications.
• To determine if intraoperative endoscopy can guide technique correction.
• To assess the impact of intraoperative endoscopy on achieving adequate fundoplication.

Main Methods:

• Retrospective observational study of 277 patients undergoing laparoscopic fundoplication (July 1999 - June 2004).
• Intraoperative endoscopy was used to evaluate the fundoplication during the procedure.
• Corrections were recorded, and changes in technique were analyzed using Student's t-test.

Main Results:

• Intraoperative endoscopy identified the need for technique correction in 77 out of 277 patients.
• An average of 1.69 changes were made per patient requiring correction.
• Common corrections included rotation/angling of the fundoplication and type changes (Nissen to Toupet) due to tightness.

Conclusions:

• Intraoperative endoscopy is effective in confirming adequate laparoscopic fundoplication technique.
• This method can help prevent inadequate procedures and potentially improve patient outcomes.
• Further research is needed to determine if routine use is justified to reduce postoperative complications.