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Related Experiment Video

Updated: Nov 27, 2025

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Modified Oesophago-Gastric Dissociation (M-OGD) - a technical modification.

Riccardo Coletta1,2, Elisa Mussi3, Adrian Bianchi4

  • 1Department of Pediatric Surgery, Meyer Children's Hospital, University of Florence, Viale Gaetano Pieraccini, 24, 50139, Florence, FI, Italy. Riccardo.coletta@meyer.it.

Updates in Surgery
|December 3, 2020
PubMed
Summary

Modified Oesophago-Gastric Dissociation (M-OGD) offers a less complex approach for redo surgery in neurologically impaired children with severe gastro-oesophageal reflux. This technique simplifies the oesophago-jejunal anastomosis, ensuring safer procedures and positive long-term outcomes.

Keywords:
Gastroesophageal refluxNeurodisabilityNeurological impairment

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Surgical Innovation

Background:

  • Severe gastro-oesophageal reflux (GOR) in neurologically impaired (NI) children often necessitates complex redo surgeries.
  • Previous anti-reflux procedures can lead to adhesions and fibrosis, complicating lower esophagus mobilization and anastomosis.
  • Existing techniques for redo surgery present significant technical challenges, particularly in laparoscopic approaches.

Purpose of the Study:

  • To present the Modified Oesophago-Gastric Dissociation (M-OGD) as a less complex technical modification of Total Oesophago-Gastric Dissociation (TOGD).
  • To evaluate the safety and efficacy of M-OGD in neurologically impaired children undergoing redo anti-reflux surgery.
  • To assess the outcomes of M-OGD, focusing on the oesophago-jejunal anastomosis and long-term results.

Main Methods:

  • The M-OGD technique involves detaching the stomach from the oesophago-gastric junction using a 5-mm stapler, leaving a small stomach strip attached to the esophagus.
  • An end-to-side isoperistaltic oesophago-jejunostomy is created between the gastric stump and a jejunal Roux loop.
  • Bowel continuity is restored with a jejuno-jejunal anastomosis.

Main Results:

  • M-OGD was performed on 3 NI patients (9-27.3 kg) between May 2018 and February 2020.
  • Median surgical time was 170 minutes, with median re-feeding time of 3 days and median length of stay of 20 days.
  • All patients achieved primary healing, with no complications related to the oesophago-jejunal anastomosis after a median follow-up of 3 months.

Conclusions:

  • M-OGD simplifies redo oesophageal surgery following failed anti-reflux procedures in NI children.
  • The technique facilitates a safer oesophago-jejunal anastomosis.
  • M-OGD demonstrates good long-term outcomes, reducing surgical complexity and improving patient recovery.