Revisional surgery after failed laparoscopic anterior fundoplication

Angus Watson, Zygmunt H Krukowski

    Research output: Contribution to journalArticle

    7 Citations (Scopus)

    Abstract

    Background: Partial fundoplication may have functional advantages over a circumferential wrap but the reconstruction is more complex. Revisional surgery for recurrent reflux may be more difficult because of the additional suturing involved in the original operation. We report experience with revisional surgery in a large cohort of patients who had undergone laparoscopic anterior fundoplication and hiatal repair.

    Methods: Between August 1993 and September 1999. 11 (3.5%) of 309 patients who had laparoscopic anterior fundoplication for uncomplicated gastroesophageal reflux disease required revisional surgery (1 open and 10 laparoscopic revisions). Data were retrieved from a prospective database supplemented by a postal questionnaire following the second operation.

    Results: The operative findings were posterior hiatal disruption (n = 9), anterior paraesophageal hernia (n = 1), and inadequate initial esophageal mobilization (n = 1). There were no conversions to open surgery in the laparoscopic group. Ten (91%) of the respondents described the outcome of their repeat procedure as either good or excellent. All patients would recommend the repeat procedure to patients with similar symptoms.

    Conclusions: Revisional surgery after laparoscopic anterior fundoplication can be performed safely with a good outcome. Modifications to technique both in the primary procedure and for revision may decrease the incidence of early technical failure.

    Original languageEnglish
    Pages (from-to)392-394
    Number of pages2
    JournalSurgical Endoscopy
    Volume16
    Issue number3
    DOIs
    Publication statusPublished - 2002

    Keywords

    • ANTIREFLUX SURGERY
    • GASTROESOPHAGEAL REFLUX
    • REOPERATION

    Cite this

    Revisional surgery after failed laparoscopic anterior fundoplication. / Watson, Angus; Krukowski, Zygmunt H.

    In: Surgical Endoscopy, Vol. 16, No. 3, 2002, p. 392-394.

    Research output: Contribution to journalArticle

    Watson, Angus ; Krukowski, Zygmunt H. / Revisional surgery after failed laparoscopic anterior fundoplication. In: Surgical Endoscopy. 2002 ; Vol. 16, No. 3. pp. 392-394.
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    abstract = "Background: Partial fundoplication may have functional advantages over a circumferential wrap but the reconstruction is more complex. Revisional surgery for recurrent reflux may be more difficult because of the additional suturing involved in the original operation. We report experience with revisional surgery in a large cohort of patients who had undergone laparoscopic anterior fundoplication and hiatal repair.Methods: Between August 1993 and September 1999. 11 (3.5{\%}) of 309 patients who had laparoscopic anterior fundoplication for uncomplicated gastroesophageal reflux disease required revisional surgery (1 open and 10 laparoscopic revisions). Data were retrieved from a prospective database supplemented by a postal questionnaire following the second operation.Results: The operative findings were posterior hiatal disruption (n = 9), anterior paraesophageal hernia (n = 1), and inadequate initial esophageal mobilization (n = 1). There were no conversions to open surgery in the laparoscopic group. Ten (91{\%}) of the respondents described the outcome of their repeat procedure as either good or excellent. All patients would recommend the repeat procedure to patients with similar symptoms.Conclusions: Revisional surgery after laparoscopic anterior fundoplication can be performed safely with a good outcome. Modifications to technique both in the primary procedure and for revision may decrease the incidence of early technical failure.",
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    AB - Background: Partial fundoplication may have functional advantages over a circumferential wrap but the reconstruction is more complex. Revisional surgery for recurrent reflux may be more difficult because of the additional suturing involved in the original operation. We report experience with revisional surgery in a large cohort of patients who had undergone laparoscopic anterior fundoplication and hiatal repair.Methods: Between August 1993 and September 1999. 11 (3.5%) of 309 patients who had laparoscopic anterior fundoplication for uncomplicated gastroesophageal reflux disease required revisional surgery (1 open and 10 laparoscopic revisions). Data were retrieved from a prospective database supplemented by a postal questionnaire following the second operation.Results: The operative findings were posterior hiatal disruption (n = 9), anterior paraesophageal hernia (n = 1), and inadequate initial esophageal mobilization (n = 1). There were no conversions to open surgery in the laparoscopic group. Ten (91%) of the respondents described the outcome of their repeat procedure as either good or excellent. All patients would recommend the repeat procedure to patients with similar symptoms.Conclusions: Revisional surgery after laparoscopic anterior fundoplication can be performed safely with a good outcome. Modifications to technique both in the primary procedure and for revision may decrease the incidence of early technical failure.

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