Robotic Fundoplication for Large Paraesophageal Hiatal Hernias.

Conclusions: The success of robotic fundoplication depends on adhering to a few important technical principles. In our experience, the robotic surgical treatment of gastroesophageal reflux disease with large paraesophageal hernias may afford the surgeon increased dexterity and is feasible with comparable outcomes compared with traditional laparoscopic approaches. PMID: 32206010 [PubMed - in process]
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research

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Abstract 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 b...
Source: The Surgical Clinics of North America - Category: Surgery Authors: Tags: Surg Clin North Am Source Type: research
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...
Source: Gastrointestinal Endoscopy Clinics of North America - Category: Gastroenterology Authors: Source Type: research
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...
Source: Surgical Clinics of North America - Category: Surgery Authors: Source Type: research
AbstractBackgroundOAGB-MGB emerged as a standard procedure, albeit RYGB remains the most frequently performed gastric bypass. Comparative studies are scarce.MethodsProspectively collected data (July 2006 to November 2017) from a large sample size and adequate follow-up were analyzed using logistic regression and linear mixed models. Total weight loss (TWL) within the first 3 years was defined as primary outcome and duration of operation, perioperative, and late complications and comorbidity remission as secondary outcomes.ResultsThree hundred twenty-four OAGB-MGBs (age 42.51 ± 11.36 years, 74.69% females) presented ...
Source: Obesity Surgery - Category: Surgery Source Type: research
This study examined the safety and efficacy when repairing defects in 2 anatomical structures (hiatus and lower esophageal sphincter) in a concomitant set of procedures in patients with hiatal hernias between 2 and 5 cm. Methods. Prospective data were collected from 99 patients who underwent hiatal hernia repair followed immediately by the TIF procedure (HH + -TIF). GERD-HRQL (Health-Related Quality of Life), RSI (Reflux Symptom Index), and GERSS (Gastroesophageal Reflux Symptom Score) questionnaires were administered before the procedure and mailed at 6 and 12 months. Results. Ninety-nine patients were enrolled, and all w...
Source: Surgical Innovation - Category: Surgery Authors: Tags: Surg Innov Source Type: research
CONCLUSION: LVG mildly increases GER, which is likely related to the development of hiatal hernias and a decrease in LES pressure and esophageal sweep. However, LVG should not be contraindicated for patients with preoperative pH-metric GER, as this may clear after the procedure. PMID: 31257899 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
AbstractBackgroundCurrent literature is conflicted regarding the efficacy of laparoscopic anti-reflux surgery (LARS) among obese patients complaining of pathologic reflux or otherwise symptomatic hiatal hernias. Controlling for other factors, this study examined the influence of preoperative body mass index (BMI) on clinical and subjective quality of life (QOL) outcomes following LARS.MethodsPatients who underwent LARS between February 2012 and April 2018 were subdivided into four BMI stratified categories according to CDC definitions: normal (18.5 to  
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Conclusion: In this series of 32 cases, laparoscopic cruroplasty with UBM graft reinforcement has been effective and durable at 12 months of followup. This technique may offer one satisfactory solution for large hiatal hernia repair concomitant with laparoscopic sleeve gastrectomy that may achieve a durable repair with low GERD symptoms. PMID: 30880900 [PubMed - in process]
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research
Abstract Gastroesophageal reflux disease, associated with sliding or large paraesophageal hiatal hernia, represents a common clinical presentation. The repair of large paraesophageal hiatal hernias is still a challenge in minimally invasive surgery. Between March 2014 and August 2016, 50 patients (18 males and 32 females) underwent robotic fundoplication (17 sliding and 33 paraesophageal hernias). The mean age of the patients was 58 years. Biosynthetic mesh was used in 28 patients with paraesophageal hernia. The mean operative time was 115 minutes (90-132) in the sliding hiatal hernia group, whereas it was 200 min...
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
CONCLUSION This case report highlights the co-existence of Morgagni and Para-esophageal hernias and validates the feasibility of laparoscopic repair of both hernias simultaneously.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
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