Open AccessLaparoscopic reoperation following failed antireflux surgery
Author(s) -
Watson D. I.,
Jamieson G. G.,
Game P. A.,
Williams R. S.,
Devitt P. G.
Publication year - 1999
Publication title -
british journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.202
H-Index - 201
eISSN - 1365-2168
pISSN - 0007-1323
DOI - 10.1046/j.1365-2168.1999.00976.x
Subject(s) - medicine , nissen fundoplication , surgery , dysphagia , laparoscopy , perioperative , hernia , reflux , open surgery , laparoscopic surgery , endoscopy , general surgery , disease
Background: The aim was to determine the feasibility of laparoscopic revision surgery following previous open and laparoscopic antireflux operations. Methods: The outcome was determined for 27 patients (14 men, 13 women) who had undergone attempted laparoscopic revision between 3 months and 25 years after a previous antireflux operation. Median follow‐up was 12 (range 3–48) months. Results: Thirteen patients had previously had an open antireflux procedure (Nissen fundoplication, seven; transthoracic anatomical repair, five; Belsey procedure, one) and 14 a laparoscopic procedure (Nissen, 12; anterior partial fundoplication, two). The indications for revision were: recurrent reflux, 15; paraoesophageal hiatus hernia, six; troublesome dysphagia, six. Fifteen procedures comprised construction of a new Nissen fundoplication, six conversion from a Nissen to a partial wrap, three repair of a paraoesophageal hernia and three widening of the oesophageal hiatus. Revision was successfully completed laparoscopically in 12 patients following a previous laparoscopic procedure and in nine following a previous open operation. Median operating time was 105 min after previous open surgery and 80 min after laparoscopic surgery. No perioperative complications occurred in either group and a good outcome was achieved in 25 of the 27 patients. Conclusion: Laparoscopic reoperative antireflux surgery is feasible. Reoperation is likely to be more difficult following failure of an open procedure than a laparoscopic one. © 1999 British Journal of Surgery Society Ltd