Related Experiment Videos
[Laparoscopic surgery of a thoracic stomach]
B Ablassmaier1, U Steinhilper, W D Bandl
1Chirurgische Abteilung, Kreiskrankenhaus München-Pasing.
Summary
Laparoscopic surgery successfully treated a 54-year-old patient with up-side-down-stomach (gastric organoaxial volvulus) causing recurrent bleeding. The procedure involved repositioning the stomach and reinforcing the diaphragmatic opening to prevent recurrence.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Minimally Invasive Surgery
Background:
- Gastric organoaxial volvulus, or up-side-down-stomach, is a rare condition often presenting with severe symptoms like recurrent gastric bleeding.
- Surgical intervention is typically required for symptomatic gastric volvulus, with laparoscopic approaches offering potential benefits in recovery.
Observation:
- A 54-year-old patient presented with recurrent gastric bleeding attributed to an up-side-down-stomach.
- The patient exhibited esophageal hypomotility but no gastroesophageal reflux symptoms.
Findings:
- Laparoscopic repositioning of the stomach, closure of the diaphragmatic defect with silk sutures, fundophrenicopexy, and corpopexy were performed.
- A polypropylene mesh was used to reinforce the hiatus, preventing hernia recurrence.
- Fundoplication was omitted due to the absence of reflux symptoms and presence of esophageal hypomotility.
Implications:
- This case highlights the successful application of a tailored laparoscopic technique for managing gastric organoaxial volvulus, addressing bleeding and preventing recurrence.
- The approach demonstrates the importance of considering esophageal motility when deciding on specific surgical steps like fundoplication.
- Laparoscopic repair of gastric volvulus can be effective, even in complex presentations, potentially reducing patient morbidity.