Laparoscopic redo nissen fundoplication after previous open antireflux surgery in infants and children

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Recurrent gastroesophageal reflux is a known complication following initial fundoplication.
• Open antireflux procedures can sometimes necessitate revision surgery.
• Pediatric patients with complex medical histories may require specialized surgical interventions.

Purpose of the Study:

• To evaluate the feasibility and safety of laparoscopic redo Nissen fundoplication in pediatric patients previously treated with open antireflux surgery.
• To assess the outcomes and complications associated with revision laparoscopic fundoplication.
• To determine the efficacy of this minimally invasive approach in managing recurrent reflux.

Main Methods:

• Retrospective review of medical records for pediatric patients undergoing laparoscopic redo Nissen fundoplication after open fundoplication.
• Analysis of operative times, intraoperative complications, postoperative feeding resumption, length of stay, and follow-up outcomes.
• Inclusion criteria focused on patients with a history of open antireflux procedures.

Main Results:

• Laparoscopic revision was successfully completed in 100% of cases with no intraoperative complications.
• Average operative time was 177.5 minutes, with a median length of stay of 3 days.
• Most patients resumed feeds on postoperative Day 1, and one patient required a subsequent procedure for persistent dysphagia.

Conclusions:

• Laparoscopic redo Nissen fundoplication is a safe and feasible surgical option for pediatric patients with recurrent reflux after open antireflux procedures.
• This minimally invasive technique offers effective management of reflux complications.
• Further investigation may be warranted for managing persistent postoperative issues like dysphagia.