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Updated: May 16, 2026

Technical Considerations and Approach to Redo Foregut Surgery
Published on: September 22, 2023
[Heterotaxy-polysplenia, approach to the esophageal hiatus for Nissen technique]
M López Díaz1, I Cano Novillo, R Tejedor Sánchez
1Hospital Universitario 12 De Octubre, Madrid. malopezd.hdoc@salud.madrid.org
Introduction:
Heterotaxy is a failure in embryonic development to achieve left-right symmetry.
Objective:
To report a case of heterotaxy and show a surgical approach for fundoplication.
Material And Methods:
A girl with heterotaxy-polysplenia syndrome with gastroesophageal reflux and recurrent abdominal pain. It was decided to perform laparoscopic antireflux treatment with Nissen fundoplication with approach by the right side of the diaphragmatic hiatus and pillars.
Conclusions:
Surgery is being discussed in these syndromes, indicating only in cases of recurrent abdominal pain, subocclusive lesions or when diagnosis of gastroesophageal reflux is done. The dilemma is between laparoscopic or classical laparotomy. The main difficulty of the laparoscopic approach is the enlarged liver and stomach placement right despite the esophageal hiatus is normally on the left side.
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