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Related Experiment Videos

The Angelchik prosthesis behaves as a fundoplication

J R Lee1, J G Temple

  • 1General Hospital, Birmingham.

Annals of the Royal College of Surgeons of England
|March 1, 1993
PubMed
Summary

The Angelchik prosthesis prevents gastro-oesophageal reflux by creating a small, intra-abdominal para-oesophageal hernia. This hernia, alongside the esophagus, is crucial for the prosthesis

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Area of Science:

  • Gastroenterology
  • Surgical Devices

Background:

  • The mechanism by which the Angelchik prosthesis prevents gastro-oesophageal reflux remains unclear.
  • Understanding the prosthesis's interaction with patient anatomy is essential for optimizing its use.

Purpose of the Study:

  • To investigate the radiological findings associated with the Angelchik prosthesis.
  • To determine the anatomical configuration required for the Angelchik prosthesis to effectively prevent gastro-oesophageal reflux.

Main Methods:

  • Retrospective review of 53 barium meal examinations in 39 patients who received the Angelchik prosthesis.
  • Analysis of prosthesis position (intra-abdominal vs. mediastinal) and the presence/absence of para-oesophageal hernia.

Main Results:

  • In 43 examinations with the prosthesis below the diaphragm, 38 showed a small intra-abdominal para-oesophageal hernia, with reflux in only one.
  • In 5 examinations where the prosthesis was abdominal without a hernia, reflux occurred in three.
  • In 10 examinations with mediastinal migration, no hernia was present and reflux occurred in eight.

Conclusions:

  • The formation of a small, intra-abdominal para-oesophageal hernia within the Angelchik prosthesis ring appears necessary for its successful function.
  • This hernia buttresses the intra-abdominal esophagus, mimicking a fundoplication effect and preventing reflux.

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