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Technical Considerations and Approach to Redo Foregut Surgery
Published on: September 22, 2023
Minimally invasive redo antireflux surgery: lessons learned
Arjun Pennathur1, Omar Awais, James D Luketich
1Heart, Lung, and Esophageal Surgery Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213-3221, USA.
The Annals of Thoracic Surgery
|May 25, 2010
Summary
Reoperative antireflux surgery, often performed laparoscopically, is complex and requires thorough evaluation. Success rates for redo procedures, including fundoplication, are lower than primary operations.
Area of Science:
- Gastroenterology and Surgical Innovation
- Minimally Invasive Surgery
Background:
- Reoperative (redo) antireflux surgery is increasingly performed laparoscopically, moving from traditional open techniques.
- Success rates for redo antireflux operations, whether open or laparoscopic, are generally lower than primary procedures.
Purpose of the Study:
- To discuss clinical presentation, patient evaluation, and causes of failure in redo antireflux surgery.
- To focus on reconstructive options and technical aspects of minimally invasive redo antireflux surgery.
Main Methods:
- Review of clinical presentation and patient evaluation for failed primary antireflux surgery.
- Discussion of reconstructive surgical options, including redo fundoplication and Roux-en Y esophagojejunostomy.
- Emphasis on the technical aspects of minimally invasive redo antireflux surgery.
Main Results:
- Redo antireflux surgery is complex, necessitating comprehensive pre-operative assessment.
- Options for failed primary surgery include reconstructive approaches and, in severe cases, esophagectomy.
- Minimally invasive techniques are being adopted for reoperative procedures.
Conclusions:
- Thorough evaluation is crucial for successful reoperative antireflux surgery.
- Minimally invasive approaches are becoming more common for redo antireflux procedures.
- Lessons learned from experience with minimally invasive redo antireflux surgery are summarized.
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