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Robotic Heller Myotomy for Advancements in Surgical Management of Achalasia

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A modified approach to laparoscopic antireflux surgery may decrease postoperative dysphagia and gas bloat syndrome.

Abdulzahra Hussain¹, Hind Mahmood, Jackie Nicholls

¹Minimal Access Unit, General Surgery Department, Princess Royal University Hospital, Farnborough Common, Orpington, Greater London, UK. azahrahussain@yahoo.com

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques

|June 17, 2010

Summary

This modified laparoscopic antireflux surgery, a spiral wrap fundoplication, shows good results. It offers acceptable morbidity and a low incidence of postoperative dysphagia and gas bloat syndrome.

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Area of Science:

Gastroenterology
Minimally Invasive Surgery

Background:

Laparoscopic antireflux surgery is effective compared to traditional methods.
Various Nissen fundoplication modifications exist with differing outcomes.

Purpose of the Study:

To evaluate a modified spiral wrap laparoscopic fundoplication technique.
Assess postoperative outcomes and patient satisfaction.

Main Methods:

A spiral wrap fundoplication using Ethibond stitches without esophageal stitching.
Clinical assessment at 6 weeks, 6 months, 12 months, and annually.
Diagnostic tests for recurrent symptoms or complications.

Main Results:

57 patients underwent the spiral wrap technique.
Low rates of heartburn (4 patients) and regurgitation (1 patient) at 1 year.
Early dysphagia (9 patients) and gas bloat (2 patients) resolved by 1 year; no revisional surgery needed.

Conclusions:

The spiral wrap modification of Nissen fundoplication is safe and effective.
Associated with acceptable morbidity and low rates of dysphagia and gas bloat syndrome.