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Technical Considerations and Approach to Redo Foregut Surgery
Published on: September 22, 2023
Efficacy and feasibility of laparoscopic redo fundoplication
Lokesh Bathla1, Andras Legner, Kazuto Tsuboi
1Department of Surgery, Creighton University Medical Center, 601, N 30th Street, Suite 3700, Omaha, NE, 68131, USA. bathlalok@gmail.com
World Journal of Surgery
|September 15, 2011
Summary
Redo anti-reflux surgery (ARS) can effectively manage recurrent symptoms. Laparoscopic redo-ARS offers excellent patient satisfaction and symptom improvement compared to open procedures, establishing its safety and efficacy.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Patient Outcomes
Background:
- 15% of patients experience recurrent symptoms after anti-reflux surgery.
- Redo anti-reflux surgery (redo-ARS) is an option for persistent symptoms.
- Previous studies show feasibility and short-term results of redo-ARS.
Purpose of the Study:
- To review outcomes of 102 redo fundoplications.
- To emphasize subjective outcomes for redo-ARS.
- To compare open versus laparoscopic redo-ARS.
Main Methods:
- Retrospective analysis of 102 redo fundoplications (Dec 2003 - Mar 2008).
- Patients divided into open (Group A) and laparoscopic (Group B) groups.
- Annual subjective symptom analysis via questionnaire.
Main Results:
- No significant difference in age, BMI, or time since first surgery.
- Laparoscopic group had shorter operative times, less blood loss, and shorter hospital stays.
- Significant symptom score improvement and reduced acid suppression therapy use in both groups.
- Excellent patient satisfaction: 58% open vs. 90% laparoscopic.
Conclusions:
- Redo laparoscopic anti-reflux surgery is safe and effective.
- Excellent short- to medium-term outcomes observed.
- Laparoscopic approach demonstrates superior patient satisfaction.
