Over 250 Laparoendoscopic Single Site (LESS) Fundoplications: Lessons Learned.

Area of Science:

• Minimally invasive surgical techniques
• Gastroenterology and surgical innovation

Background:

• Gastroesophageal reflux disease (GERD) significantly impacts patient quality of life.
• Minimally invasive surgery, including Laparoendoscopic Single-Site (LESS) surgery, aims to reduce patient morbidity.
• LESS surgery represents an advancement in surgical approaches for GERD management.

Purpose of the Study:

• To evaluate the outcomes and patient experience after LESS fundoplication for GERD.
• To assess symptom relief, patient satisfaction, and cosmetic results following LESS fundoplication.
• To identify lessons learned from the initial series of LESS fundoplications.

Main Methods:

• Prospective follow-up of patients undergoing LESS fundoplication for GERD between 2008 and 2014.
• Utilized Likert scales for patients to score symptom frequency/severity and incision satisfaction.
• Analysis of patient-reported outcomes, including symptom scores and overall satisfaction.

Main Results:

• Significant amelioration of preoperative GERD symptoms, including heartburn (frequency and severity reduced to 0, P < 0.01).
• High patient satisfaction with incision cosmesis (median score of 10).
• 83% of patients were satisfied with their overall experience, and 92% would undergo the procedure again.

Conclusions:

• LESS fundoplication is a safe and effective treatment for GERD, leading to substantial symptom improvement.
• Excellent cosmetic outcomes and high patient satisfaction contribute to the overall success of LESS fundoplication.
• The application of LESS fundoplication for GERD is encouraged due to its favorable patient-reported outcomes.