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Laparoscopic and thoracoscopic antireflux surgery

P J Roberts1, A Cuschieri

  • 1Department of Surgery, Ninewells Hospital and Medical School, University of Dundee, Scotland.

Annales Chirurgiae Et Gynaecologiae
|January 1, 1995
PubMed
Summary

Surgical treatment for gastro-oesophageal reflux disease (GERD) remains crucial for patients unresponsive to medication or experiencing complications. Advances in minimal access surgery, including laparoscopic and thoracoscopic antireflux procedures, offer effective alternatives with comparable short-term outcomes to open surgery.

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Area of Science:

  • Gastroenterology and Surgical Innovation
  • Minimally Invasive Surgical Techniques

Background:

  • Proton pump inhibitors like omeprazole effectively manage gastro-oesophageal reflux disease (GERD) symptoms for many.
  • Persistent GERD symptoms, medication noncompliance, or complications necessitate surgical intervention.
  • Traditional open surgery for GERD has limitations, prompting the exploration of alternative approaches.

Purpose of the Study:

  • To review the current indications for surgical treatment of GERD.
  • To explore the evolution of surgical approaches towards minimally invasive techniques for GERD.
  • To present a review of laparoscopic and thoracoscopic antireflux procedures.

Main Methods:

  • Review of existing literature on surgical treatments for GERD.
  • Focus on endoscopic and minimally invasive surgical procedures, including laparoscopic and thoracoscopic fundoplication.

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  • Comparison of outcomes between open and minimally invasive antireflux surgeries.

    • Main Results:

    • Minimally access surgery, including laparoscopic and thoracoscopic antireflux procedures, can replicate essential open surgical steps.
    • Laparoscopic fundoplication is the primary minimally invasive approach; thoracoscopic approach is reserved for specific patient groups (e.g., short esophagus, morbid obesity).
    • Short-term results of endoscopic antireflux surgery are comparable to those of open surgery.

    Conclusions:

    • Surgical intervention for GERD is indicated when medical management fails or complications arise.
    • Minimally invasive antireflux surgery, particularly laparoscopic and thoracoscopic fundoplication, offers a viable and effective treatment option.
    • Endoscopic antireflux procedures demonstrate comparable short-term efficacy to traditional open surgical methods.