Laparoscopic Wedge Fundectomy for Collis Gastroplasty Creation in Patients With a Foreshortened Esophagus

Abstract

The laparoscopic wedge-fundectomy Collis gastroplasty can be performed safely and is associated with a low prevalence of new-onset dysphagia and esophagitis. The addition of a Collis gastroplasty to an antireflux operation is an effective strategy in patients with short esophagus, and its more liberal use is encouraged.

Massive hiatal hernia: a review

“…Deschamps at the Mayo Clinic and Luketich have proposed the ‘wedge gastroplasty’. This technique was used and reported by Zehetner et al . and Whitson with short‐term results comparable to those of the open thoracic approach.…”

“…45,48,65,66,68,74 Deschamps 71 at the Mayo Clinic and Luketich 45 have proposed the 'wedge gastroplasty'. This technique was used and reported by Zehetner et al 70 and Whitson with short-term results comparable to those of the open thoracic approach. A meta-analysis by Rathore et al 75 has even suggested that the use of the Collis Nissen gastroplasty provides a significant protective influence against the high recurrence rate reported.…”

Esophageal Mobilization in the Treatment of Short Esophagus

“…This method has been criticized because of the presence of parietal cells that secrete gastric acid in neoesophagus and because of reduced motility that allows direct contact between the acidic contents and mucosa of the esophagus (1,11,19). Despite this gastroplasty and fundoplication can be effective in controlling symptoms of the reflux (10,17). Traditionally, in patients with suspected syndrome of short esophagus is conducted transthoracic fundoplication because this approach provides ideal conditions for the mobilization of the esophagus and allows Collis gastroplasty when it is needed.…”

“…A fundoplication performed around an intrinsically short esophagus without a lengthening procedure will have a high failure rate because of mediastinal wrap herniation or disruption due to excessive tension. This is believed to be responsible for approximately 20-35% of the surgical failures after open or laparoscopic antireflux surgery (8)(9)(10). In the era of laparoscopic antireflux surgery it is imperative to identify the short esophagus preoperatively.…”

Updates on Management of GERD Disease

“…Collis gastroplasty: This method consists in transforming the upper part of the small curve into tube form [22], in continuity with the esophagus. Collis gastroplasty is a surgical procedure performed when the surgeon wants to create a Nissen fondiplication, but the portion of the esophagus lower than the diaphagm is too short.…”