Gastro-esophageal Reflux After Laparoscopic Gastrostomy Placement in Children
Conclusions: Overall, gastrostomy placement was not associated with an increase in acid exposure on 24-hour multichannel intraluminal impedance pH monitoring. Similarly, the prevalence of gastro-oesophageal reflux-related symptoms did not change after gastrostomy.
The main side effect of long-term laparoscopic sleeve gastrectomy (LSG) is the onset of severe gastroesophageal reflux disease (GERD).
Every once in a while, a field that has felt static for decades begins to move. Gastroesophageal reflux disease (GERD) is in one of those times. GERD is a big modern problem with estimates of significant GERD in some 30 million in the United States. For a long while, treatment has boiled down to 2 options: the pill (proton pump inhibitors, PPIs) or the knife (laparoscopic fundoplication). There is no doubt that these treatments benefit a majority of patients suffering from GERD but have also left many dissatisfied.
ConclusionsComparative trials remain necessary between N-Sleeve and standard bariatric procedures to refine the specific indications of each of them and determine the eventual role of the N-Sleeve.
Magnetic sphincter augmentation is an effective and safe surgical method for the treatment of gastroesophageal reflux disease (GERD). The device has been compared with twice-daily proton pump inhibitor therapy and laparoscopic fundoplication (in randomized trials and prospective cohort studies, respectively). Magnetic sphincter augmentation was superior to medical therapy and equivalent to surgery for the relief of GERD symptoms. Recent research focuses on implanting the device into more complex patients, such as those with larger hiatal hernias or those with Barrett ’s esophagus. Additional novel research topics inc...
Robotic-assisted surgery for benign esophageal disease is described for treatment of achalasia, gastroesophageal reflux, paraesophageal hernias, epiphrenic diverticula, and benign esophageal masses. Robotic Heller myotomy has operative times, relief of dysphagia, and conversion rates comparable to laparoscopic approach, with lower incidence of intraoperative esophageal perforation. The use of robotic platform for primary antireflux surgery is under evaluation, due to prolonged operative time and increased operative costs, with no differences in postoperative outcomes or hospital stay. Studies have shown benefits of robotic...
Antireflux surgery is challenging, and has become even more challenging with the introduction of alternative endoscopic and laparoscopic options for patients with gastroesophageal reflux disease (GERD). The Nissen fundoplication remains the gold standard for the durable relief of GERD symptoms and esophagitis. All antireflux procedures have a failure rate, and it is important to minimize factors that are associated with failure. The selection of patients for antireflux surgery as well as the choice of the procedure requires a thorough understanding of esophageal physiology and the pros and cons of various options.
AbstractObjectiveTo evaluate the impact of laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) on gastroesophageal reflux disease (GERD) in patients with obesity.MethodsPatients with class II or III obesity were treated with LSG or LRYGB. Procedure choice was based on patients and surgeon preferences. GERD symptoms, endoscopy, barium swallow X-ray, esophageal manometry, and 24-h pH monitoring were obtained before and 1 year after surgery.ResultsSeventy-five patients underwent surgery (83% female, 39.3 ± 12.1 years, BMI of 41.5 ± 5.1 kg/m2): 35 (46.7%) had LSG and 40 (53.3%) ...
ConclusionOur data revealed that pre ‐embedded cervical circular stapled anastomosis is an alternative for patients with good stomach length, which can decrease the occurrence rate of anastomotic fistula by full peripheral embedding of anastomotic stoma.Key points This new technique can significantly reduce the risk of anastomotic leakage. This study adds further details enabling a smooth pre ‐embedded procedure to be performed.
ConclusionsVarious reports published in the literature suggested that the robot-assisted approach was effective and was associated with very low postoperative morbidity and was accompanied by satisfactory symptomatic and anatomical radiological outcomes during a follow-up period.The robotic approach to paraesophageal repair is safe and effective with low complication rates. With increased experience, the operative time, length of stay, and complications decrease without compromising surgical principles.
ConclusionsPatients who undergo reoperative fundoplication experience a significant improvement in their GERD-related symptoms, although not to the degree seen in primary antireflux surgery patients. Perioperative morbidity rates following reoperative and primary procedures can be similar in the hands of an experienced surgeon.