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Laparoscopic Thal fundoplication in mentally retarded children
1Department of Pediatric Surgery, University Children's Hospital Wilhelmina, P.O. Box 18009, 3501 CA, Utrecht, The Netherlands.
Surgical Endoscopy
|June 1, 1996
Summary
Laparoscopic Thal fundoplication is a safe and effective surgical option for mentally retarded children, offering comparable outcomes to open procedures. This minimally invasive approach can successfully manage gastroesophageal reflux in this vulnerable population.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Thal fundoplication is increasingly recommended for mentally retarded children.
- Laparoscopic techniques are gaining popularity for anti-reflux procedures.
- Evaluating laparoscopic Thal fundoplication's efficacy in this specific population is crucial.
Purpose of the Study:
- To assess the benefits and outcomes of laparoscopic Thal fundoplication in mentally retarded children.
- To compare laparoscopic results with traditional open Thal fundoplication.
Main Methods:
- A cohort of 15 mentally handicapped children underwent laparoscopic Thal fundoplication between November 1993 and 1994.
- 13 patients also received a feeding gastrostomy.
- Pre- and postoperative upper GI studies, endoscopy, and pH monitoring were conducted.
Main Results:
- The laparoscopic procedure was converted to open surgery in one patient due to bleeding.
- No other major intra- or postoperative complications were reported.
- Postoperative pH studies showed no symptomatic gastroesophageal reflux, with silent reflux in two patients.
Conclusions:
- Laparoscopic Thal fundoplication is a feasible surgical option for mentally retarded children.
- The outcomes of the laparoscopic approach are comparable to those of open Thal fundoplication.
- This minimally invasive technique is well-tolerated and effective in managing reflux in this population.