Reiterative laparoscopic surgery for recurrent gastroesophageal reflux

Laparoscopic Nissen fundoplication is successful in preventing reflux in more than 95% of patients. However, over time, there appears to be failure of the fundoplication either with wrap breakdown and/or transmigration of the wrap through the esophageal hiatus in 5% to 10% of patients. It is unlikel...

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Bibliographic Details
Published in:Seminars in pediatric surgery 2007-11, Vol.16 (4), p.252-258
Main Authors: Ostlie, Daniel J., MD, Holcomb, George W., MD, MBA
Format: Article
Language:English
Subjects:
Female
Fundoplication - methods
Gastroesophageal reflux
Gastroesophageal Reflux - physiopathology
Gastroesophageal Reflux - surgery
Humans
Infant
Intubation, Gastrointestinal
Laparoscopic fundoplication
Laparoscopy
Male
Nissen fundoplication
Pediatrics
Recurrence
Reoperation
Reoperative laparoscopic surgery
Surgery
Suture Techniques
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Summary:Laparoscopic Nissen fundoplication is successful in preventing reflux in more than 95% of patients. However, over time, there appears to be failure of the fundoplication either with wrap breakdown and/or transmigration of the wrap through the esophageal hiatus in 5% to 10% of patients. It is unlikely that medical management will be successful in controlling the reflux symptoms following either wrap breakdown and/or transmigration. Thus, operative repair for control of recurrent symptoms is required in most cases. This article outlines the etiology for recurrent gastroesophageal reflux disease, presentation of the patient with wrap failure or transmigration, steps which the authors have taken to help prevent these complications from developing, and our approach for those patients who require re-operation.
ISSN:1055-8586
1532-9453
DOI:10.1053/j.sempedsurg.2007.06.007