[Esophageal and cardial risk of treating gastroesophageal reflux by laparoscopic surgery]

A qualitative study of risk was performed on 4 forensic files and on accidents published in the literature (1,609 cases). The surgeon may be charged with the responsibility of specific complications involving the oeso-cardial-tuberosity junction including perforation of the esophagus (13 cases), perforation of the stomach (8 cases) and necrosis of the Nissen valve by ischemia after section of the short vessels of the lesser curvature (2 cases). Sudden migration into the mediastinum or the left pleural space may occur after laparoscopic surgery (23 cases). As for all surgery, it is the surgeon's responsibility to provide adequate means for the indicated procedure and to perform the operation and follow-up. Since this is a new technique, the severity of judgements increases with the notion of special risk and aggravated risk.