Minimally Invasive Surgical Techniques for the Treatment of Gastroesophageal Reflux Disease

Abstract

Open antireflux surgery produces good long-term control of disease, but new interest in the surgical management of gastroesophageal reflux disease has been stimulated by the introduction of minimally invasive techniques to perform standard antireflux procedures. In the past some scepticism existed among gastroenterologists who quoted the poor surgical results they had seen. These bad results, however, were largely due to inappropriate surgery in poorly worked-up patients or antireflux surgery performed by inexperienced surgeons. Since the introduction of minimally invasive surgery for gastroesophageal reflux disease, excellent results have been reported with over 5 years of follow-up. The most common and successfully used laparoscopically antireflux procedures are reviewed and results analyzed.

Laparoscopic fundoplication: learning curve and patient satisfaction

“…Other published studies have shown excellent results with 5-year follow-up. 10 Even within the learning curve, the patient satisfaction is quite high and this is likely to remain the same or even improve as the surgeon gains more experience. Our conversion rate of 23.6% during the learning curve compares quite favourably with other published series from North America and Australia 5,11,12 all of which reported a conversion rate of 20% for the first 100 cases.…”

Laparoscopic repair for perforated peptic ulcer disease

“…The appearance of laparoscopy in the late 1980s marked a milestone in surgery. Its advantages of diminished pain, surgical wound complications, hospital stay and global costs in uncomplicated cases of gallbladder disease (Gadacz 2000) led to the expansion of its use to other intra-abdominal organs such as the distal oesophagus, the proximal stomach (Chekan 1999;Consensus 1997;Horgan 1997;Klingler 1999) and the colon (Rickard 2001;Tisminezky 2000).…”

Risk factors for recurrent gastroesophageal reflux disease after fundoplication in pediatric patients: a case-control study

“…Because many cases of rGERD involve mechanical failure, such as hiatal herniation, slippage of the wrap, or wrap dehiscence [10,13,[28][29][30][31][32][33][34][35], factors that might relate to impaired healing and increased mechanical stress were also investigated. These included systemic factors that might impair healing, such as nutritional status and steroid use.…”