Laparoscopic partial posterior fundoplication improves poor oesophageal contractility in patients with gastrooesophageal reflux disease

Wetscher, Gerold J.; Glaser, K.; Gadenstätter, Michael; Wieschemeyer, Thomas; Profanter, Christoph; Klingler, Paul J.

doi:10.1080/110241598750005561

Cited by 16 publications

(8 citation statements)

References 14 publications

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“…Nissen fundoplication was performed in 91.3% of patients who had normal esophageal body function, and partial posterior Toupet fundoplication was completed in the remaining 8.7% of patients with impaired esophageal peristalsis [63][64][65][66]. The perioperative morbidity rate of 2.9% included intraoperative bleeding in six patients (1.1%), organ injury in seven (1.2%), pneumothorax in one (0.1%), and postoperative pneumonia/pulmonary embolism in three patients (0.5%).…”

Section: Resultsmentioning

confidence: 99%

The use of medication after laparoscopic antireflux surgery

et al. 2009

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Section: Resultsmentioning

confidence: 99%

The use of medication after laparoscopic antireflux surgery

et al. 2009

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“…Despite reports of improved dysphagia following surgery, postoperative dysphagia remains a significant problem, with reported reoperation rates ranging from 1.8 to 10.8% [33,34,38,39,143,196,[205][206][207] (level I-III) and endoscopic dilatation rates ranging from 0 to 25% [34,121,143,145,189,195,196,[208][209][210][211][212][213] (level I-III). Although perioperative and early postoperative dysphagia have been reported as high as 76% [191] (level II), the majority of studies show early and mid dysphagia rates, up to 1 year postoperatively, of less than 20% [33,34,38,39,44,47,120,122,189,191,192,195,196,199,200,209,210,212,[214][215][216][217][218][219][220][221] (level I-III) and...…”

Section: Discussionmentioning

confidence: 99%

Guidelines for surgical treatment of gastroesophageal reflux disease

et al. 2010

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PreambleThe guidelines for the surgical treatment of gastroesophageal reflux disease (GERD) are a series of systematically developed statements to assist physicians and patient decisions about the appropriate use of laparoscopic surgery for GERD. The statements included in this guideline are the product of a systematic review of published literature on the topic, and the recommendations are explicitly linked to the supporting evidence. The strengths and weaknesses of the available evidence are highlighted and expert opinion sought where the evidence is lacking. This is an update of previous guidelines on this topic (last revision 06/2001) as new information has accumulated. DisclaimerGuidelines for clinical practice are intended to indicate preferable approaches to medical problems as established by experts in the field. These recommendations will be based on existing data or a consensus of expert opinion when little or no data are available. Guidelines are applicable to all physicians who address the clinical problem(s) without regard to specialty training or interests, and are intended to indicate the preferable, but not necessarily the only, acceptable approaches due to the complexity of the healthcare environment. Guidelines are intended to be flexible. Given the wide range of specifics in any health care problem, the surgeon must always choose the course best suited to the individual patient and the variables in existence at the moment of decision.Guidelines are developed under the auspices of the Society of American Gastrointestinal and Endoscopic Surgeons and its various committees, and approved by the Board of Governors. Each clinical practice guideline has been systematically researched, reviewed, and revised by the guidelines committee, and reviewed by an appropriate multidisciplinary team. The recommendations are therefore considered valid at the time of its production based on the data available. Each guideline is scheduled for periodic review to allow incorporation of pertinent new developments in medical research knowledge, and practice. Literature review methodWe identified 448 relevant articles. The abstracts were reviewed by four committee members (D.S., W.W.H., P.R.R., G.P.K.) and divided into the following categories:(a) Randomized studies, metaanalyses, and systematic reviews (b) Prospective studies (c) Retrospective studies (d) Case reports (e) Review articles Randomized controlled trials, metaanalyses, and systematic reviews were selected for further review, along with prospective and retrospective studies that included at least 50 patients. Studies with smaller samples were considered when additional evidence was lacking. The most recent reviews were also included. All case reports, older reviews, and smaller studies were excluded. According to these exclusion criteria, 227 articles were reviewed. Whenever the available evidence from level I studies was considered to be adequate, lower evidence level studies were not considered. A review of the available evidence on endoluminal treatment of...

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“…Due to poor esophageal body motility a partial posterior fundoplication was performed in all of the patients [17,18]. The DaVinci operation robot system (Intuitive Surgical, Mountain View, Calif., USA) was used in each of the operations.…”

Section: Operation Techniquesmentioning

confidence: 99%

Robot-assisted laparoscopic partial posterior fundoplication with the DaVinci system: initial experiences and technical aspects

Wykypiel

Wetscher

Alexander

et al. 2003

Langenbecks Arch Surg

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Background: This pilot study evaluated the role of the DaVinci operation robot for laparoscopic antireflux surgery. Patients and methods: A robotassisted la-paroscopic Toupet-fundoplication was performed on nine consecutive patients with severe gastroesophageal reflux disease using the DaVinci robot system. The operative procedure was performed in the same way as for the conventional laparoscopic procedure. Clinical assessment and endoscopic and manometric follow-up investigations were performed 6 months after surgery in six of the patients. Results: The mean robotic operative time was 173 min (120-235). A mean of 25 min (12-45) was required to establish the pneumoperitoneum, to set the trocars, and to place the robot arms. There were no intraoperative complications. Six months after surgery none of the patients suffered from reflux symptoms and none of the patients had acute esophagitis. Postoperatively one patient complained of mild transient dysphagia. However, persistent dysphagia was not found in any of the patients. One further patient complained of mild bloating. No other side effects occurred. Manometrically there was a significant improvement in the function of the lower esophageal sphincter. Conclusions: The robot-assisted partial posterior fundoplication is a safe procedure and provides a highquality three-dimensional camera image that is superior to that with the conventional laparoscopic device. The handling of the instruments is precise, and intracorporeal suturing and knot tying is much easier than without the robotic technique. The procedure allows for an accurate approximation of the hiatal crura and for precise construction of the fundic wrap. However, robotic surgery is expensive and the setup of the system is time consuming at present.

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Laparoscopic partial posterior fundoplication improves poor oesophageal contractility in patients with gastrooesophageal reflux disease

Abstract: Partial posterior fundoplication improves poor oesophageal body motility. This results in improvement of preoperative dysphagia.

Cited by 16 publications

References 14 publications

The use of medication after laparoscopic antireflux surgery

The use of medication after laparoscopic antireflux surgery

Guidelines for surgical treatment of gastroesophageal reflux disease

Robot-assisted laparoscopic partial posterior fundoplication with the DaVinci system: initial experiences and technical aspects

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