Surgeon variation in severity of reflux symptoms after sleeve gastrectomy

ConclusionsWe found that 1/3 of patients had worsening symptoms of reflux after LSG and that severity of symptoms varied. Surgeons with the highest rates of worsening reflux had similar operative experience and complication rates than those with the lowest. Further assessment of operative technique and skill may be informative.
Source: Surgical Endoscopy - Category: Surgery Source Type: research

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Transoral incisionless fundoplication (TIF) is an alternative treatment for gastroesophageal reflux disease (GERD). Ideal candidates are limited to patients with hiatal hernia (HH) and diaphragmatic hiatus £ 2cm and Hill Grade (HG) I or II. A novel approach of TIF immediately preceded by HH repair, coined concomitant TIF (cTIF), has emerged as a possible solution to address these limitations.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Poster abstracts Source Type: research
Transoral incisionless fundoplication (TIF) is a lesser invasive endoscopic procedure for gastroesophageal reflux disease (GERD) alternative tolaparoscopic Nissen fundoplication (LNF). Many patients with GERD require hiatal hernia (HH) repair. The US Food and Drug Administration expanded the indication of TIF for patients with hiatal hernia> 2 cm with concomitant HH repair. Recent studies demonstrated favorable outcomes of TIF with HH repair. Data comparing this modality with conventional LNF is lacking.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Oral abstracts Source Type: research
Tertiary-care referral hospital.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original articles Source Type: research
AbstractBackgroundDifferent surgical variations have been described for laparoscopic crural repair however, the technique is not standardized and left to the surgeons ’ preference.ObjectiveThe purpose of this study is to describe a standardized “patient tailored” approach for laparoscopic posterior cruroplasty in the setting of elective hiatal hernia repair.MethodsRetrospective single-center study was conducted (November 2015 to November 2019). The technical aspects of a standardized “patient tailored” laparoscopic posterior crural repair are described. Perioperative outcomes and patients&rsqu...
Source: Hernia - Category: Sports Medicine Source Type: research
AbstractIntroductionThe purpose of this study is to evaluate the utility of using a functional lumen imaging probe (EndoFLIP ™) intra-operatively during hiatal hernia repair and fundoplication. Additionally, we hypothesize that these measurements correlate with long-term outcomes.MethodsA prospectively maintained quality database was queried. Between 2013 and 2018, 175 patients underwent laparoscopic fundoplication, the majority of which also had a hiatal hernia repair. The EndoFLIP ™ was used to measure minimum diameter (Dmin), balloon pressure, and distensibility index (DI) at different timepoints throughout ...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractBackgroundMinimally invasive antireflux surgery has been shown to be safe and effective for the treatment of gastroesophageal reflux (GERD) in elderly patients. However, there is a paucity of data on the influence of advanced age on long-term quality of life (QoL) and perioperative outcomes after laparoscopic antireflux surgery (LARS).MethodA retrospective study of patients undergoing LARS between February 2012 and June 2018 at a single institution was conducted. Patients were divided into four age categories. Perioperative data and quality of life (QOL) outcomes were collected and analyzed.ResultsA total of 492 pa...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
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.
Source: Gastrointestinal Endoscopy Clinics of North America - Category: Gastroenterology Authors: Source Type: research
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.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Authors: Rouphael C, Shakya S, Arora Z, Gabbard S, Rice T, Lopez R, Raja S, Murthy S, Thota PN Abstract Background and aims: Acid suppressive therapy (AST) is frequently used after fundoplication. Prior studies show that most patients requiring AST after fundoplication have normal esophageal acid exposure and therefore do not need AST. Our aim was to determine the indications for AST use following fundoplication and the associated factors.Methods: Retrospective analysis of patients who underwent fundoplication at our institution between 2006 and 2013 with pre and postoperative esophageal physiologic studies was per...
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Hiatal hernia repair is an essential step to reduce the incidence of gastroesophageal acid reflux disease in patients undergoing sleeve gastrectomy. The safety of addition, a hiatal hernia repair to sleeve gastrectomy, is a critical question.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original article Source Type: research
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