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Type: Journal article
Title: Laparoscopic reoperation following failed antireflux surgery
Author: Watson, D.
Jamieson, G.
Game, P.
Williams, R.
Devitt, P.
Citation: British Journal of Surgery, 1999; 86(1):98-101
Issue Date: 1999
ISSN: 0007-1323
Abstract: <h4>Background</h4>The aim was to determine the feasibility of laparoscopic revision surgery following previous open and laparoscopic antireflux operations.<h4>Methods</h4>The outcome was determined for 27 patients (14 men, 13 women) who had undergone attempted laparoscopic revision between 3 months and 25 years after a previous antireflux operation. Median follow-up was 12 (range 3-48) months.<h4>Results</h4>Thirteen patients had previously had an open antireflux procedure (Nissen fundoplication, seven; transthoracic anatomical repair, five; Belsey procedure, one) and 14 a laparoscopic procedure (Nissen, 12; anterior partial fundoplication, two). The indications for revision were: recurrent reflux, 15; paraoesophageal hiatus hernia, six; troublesome dysphagia, six. Fifteen procedures comprised construction of a new Nissen fundoplication, six conversion from a Nissen to a partial wrap, three repair of a paraoesophageal hernia and three widening of the oesophageal hiatus. Revision was successfully completed laparoscopically in 12 patients following a previous laparoscopic procedure and in nine following a previous open operation. Median operating time was 105 min after previous open surgery and 80 min after laparoscopic surgery. No perioperative complications occurred in either group and a good outcome was achieved in 25 of the 27 patients.<h4>Conclusion</h4>Laparoscopic reoperative antireflux surgery is feasible. Reoperation is likely to be more difficult following failure of an open procedure than a laparoscopic one.
Keywords: Humans
Gastroesophageal Reflux
Postoperative Complications
Treatment Failure
Follow-Up Studies
Time Factors
DOI: 10.1046/j.1365-2168.1999.00976.x
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Surgery publications

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