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Inflammatory Bowel Disease V: Surgical Management

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:

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Related Experiment Video

Updated: Jun 10, 2025

Author Spotlight: Recent Advancements in Reoperative Foregut Surgery

Author Spotlight: Recent Advancements in Reoperative Foregut Surgery

Published on: September 22, 2023

Fundoplication: Old Concept for Novel Challenges?

Luigi Bonavina¹, Davide Bona², Alberto Aiolfi²

¹Division of General and Foregut Surgery, Department of Biomedical Sciences for Health, IRCCS Policlinico San Donato, University of Milan, Milan, Italy.

Visceral Medicine

|October 14, 2024

Summary

This summary is machine-generated.

Proton pump inhibitors are ineffective for many with gastroesophageal reflux disease (GERD). Laparoscopic antireflux surgery offers a safe and effective alternative, with partial fundoplications showing promise for improved quality of life.

Keywords:

Angle of His Antireflux surgery Barrett’s esophagus Crural repair Esophageal adenocarcinoma Esophagogastric junction Fundoplication Gastric sling fibers Gastroesophageal flap valve Gastroesophageal reflux disease Hiatus hernia Lower esophageal sphincter

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Area of Science:

Gastroenterology and Surgical Innovation

Background:

Gastroesophageal reflux disease (GERD) is a prevalent esophageal disorder with potential progression to Barrett's esophagus and adenocarcinoma.
Up to 40% of patients do not respond effectively to initial proton pump inhibitor therapy.
Surgical intervention aims to restore the natural antireflux barrier, including the diaphragmatic crura, lower esophageal sphincter, and gastroesophageal flap valve.

Purpose of the Study:

To evaluate the efficacy and outcomes of different surgical approaches for GERD.
To compare the effectiveness of Nissen fundoplication with partial fundoplications (Toupet and Dor).
To explore advancements in surgical procedures for improved, personalized, and durable GERD treatment.

Main Methods:

Review of randomized and observational clinical studies comparing Nissen and partial fundoplications.
Analysis of outcomes related to reflux control, anatomical integrity, and patient quality of life.
Consideration of laparoscopic antireflux surgery techniques tailored to individual GERD phenotypes.

Main Results:

The 360° Nissen fundoplication has been the gold standard, but partial fundoplications (Toupet, Dor) are emerging alternatives.
Partial fundoplications demonstrate comparable outcomes to Nissen fundoplication, with reduced incidence of dysphagia and gas-bloat syndrome.
While partial fundoplications offer satisfactory quality of life and minimize side effects, long-term reflux control and anatomical integrity require further investigation.

Conclusions:

Laparoscopic antireflux surgery is a safe and effective treatment for GERD.
Partial fundoplications present a viable alternative to Nissen fundoplication, improving patient quality of life.
Ongoing research into new surgical procedures and technologies is crucial for enhancing clinical outcomes and personalizing GERD therapy.