Outcomes of Revisional Fundoplication Surgery

Abstract

Outcomes following revisional fundoplication procedures are very good in the hands of experienced surgeons. Minimally invasive approaches with laparoscopy or robotic surgical systems are feasible with low conversion rates. Proper patient selection and evaluation are essential. Morbidity, length of stay, and operative time all tend to increase in revisions. This is especially true as the number of prior fundoplication attempts increases. GERD outcomes, quality of life, and patient satisfaction are excellent. Outcomes appear to be durable with recurrence rates slightly higher than recurrence rates following primary fundoplication.

Preface to Revisional Antireflux Surgery

“…This edition of Foregut brings together experts from around the country to discuss at length various aspects of “failed antireflux surgery.” The authors discuss basic issues such as endoscopic assessment of post-fundoplication anatomy ( Dr. Ayazi ) 1 as well as gastrointestinal ( Dr. Chandra ) 2 and surgical (Dr. Kroh) 3 perspectives of patient symptoms and evaluation. Extensive reviews on the transthoracic approach ( Dr. Bremner ), 4 Roux-en-Y reconstruction ( Dr. Awais ), 5 gastroparesis ( Dr. Black ), 6 esopahgogastric resection ( Dr. Wisniowski ), 7 and outcomes after reoperative intervention ( Dr. Xu ) 8 follow. We round off this edition with a section on technical aspects of reoperative procedures (Dr. Khaitan).…”