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Laparoscopic fundoplication

L T Medina1, R Veintimilla, M D Williams

  • 1Saint Joseph Hospital, Denver, Colorado, USA.

Journal of Laparoendoscopic Surgery
|August 1, 1996
PubMed
Summary
This summary is machine-generated.

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Laparoscopic fundoplication is effective and safe in community hospitals, even for patients with severe reflux. This study shows good outcomes and manageable complications, demonstrating feasibility outside specialized centers.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Laparoscopic fundoplication is typically reported from tertiary centers.
  • This study examines outcomes from a single surgeon in community hospitals.

Purpose of the Study:

  • To assess the feasibility, safety, and efficacy of laparoscopic fundoplication in a community hospital setting.
  • To evaluate outcomes for patients with severe gastroesophageal reflux disease (GERD).

Main Methods:

  • A retrospective review of 74 laparoscopic fundoplication cases performed by a single surgeon.
  • Patients predominantly had severe esophagitis and incompetent lower esophageal sphincter.
  • Procedures included Nissen or Toupet fundoplication, with attention to wrap technique.

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Main Results:

  • 89% of patients experienced complete reflux relief.
  • Mean hospital stay was 2.8 days.
  • Complications included one conversion to open surgery, minor infections, and one anesthesia-related death. Postoperative dysphagia occurred in 26%.

Conclusions:

  • Laparoscopic fundoplication is technically feasible, safe, and effective in community hospitals.
  • Careful surgical technique, including creating a loose wrap, is crucial for minimizing complications like dysphagia.
  • This procedure offers a viable alternative to specialized centers for GERD treatment.