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Robotic Myotomy and Partial Fundoplication for Achalasia

Robotic Myotomy and Partial Fundoplication for Achalasia

Published on: August 11, 2023

Laparoscopic conversion from Nissen to partial fundoplication for refractory dysphagia.

Stephen H McKellar¹, Mark S Allen, Stephen D Cassivi

¹Division of General Thoracic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

The Annals of Thoracic Surgery

|March 1, 2011

Summary

Laparoscopic Nissen fundoplication can cause persistent dysphagia. Converting to partial fundoplication offers relief for patients experiencing difficulty swallowing after the initial surgery.

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Area of Science:

Gastroenterology
Surgical Innovation
Minimally Invasive Surgery

Background:

Laparoscopic Nissen fundoplication effectively treats gastroesophageal reflux disease.
A subset of patients develop refractory postoperative dysphagia, impacting quality of life.
Current conservative management strategies for this dysphagia are often insufficient.

Purpose of the Study:

To describe the technique and outcomes of converting laparoscopic Nissen fundoplication to partial fundoplication.
To evaluate the efficacy of this conversion procedure in alleviating dysphagia.
To report on patient safety and short-term results.

Main Methods:

Retrospective review of medical records for 6 patients.
Patients had refractory dysphagia post-laparoscopic Nissen fundoplication.
Laparoscopic conversion to partial fundoplication was performed using a linear stapler.

Main Results:

No perioperative deaths occurred.
No fundoplication-related complications were reported.
All patients experienced improvement in dysphagia symptoms during short-term follow-up.

Conclusions:

Laparoscopic conversion to partial fundoplication is a safe and effective treatment for refractory dysphagia after Nissen fundoplication.
This surgical revision provides significant symptomatic relief.
Further research can explore long-term outcomes and patient selection criteria.