Background: Gastroesophageal reflux disease (GERD) is common in obese individuals in around 30%. While fundoplication is the treatment of choice in non-obese individuals with GERD resistant to medical treatment, the laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most effective option in the setting of morbid obesity to treat at the same time both GERD and obesity.
Methods: We present the case of a 31-year-old woman with a BMI of 37 kg/m who underwent an open Nissen fundoplication in 2010 and surgical revision in 2012 with redo of the Nissen fundoplication. She consulted for dysphagia and obesity complicated by invalidating arthrosis. A barium swallow showed esophageal dilatation and cardial stenosis. Manometry revealed incomplete waves and high pressure at the lower esophageal sphincter. We decided to convert the Nissen fundoplication to Roux-en-Y gastric bypass (RYGB).
Results: In this video, we show how to revise Nissen fundoplication to RYGB. The intervention starts by complete dissection of the gastric valve and the hiatal region from right to left. Then, a short gastric pouch is created taking care to exclude the gastric fundus that is also partially resected. We perform a hand-sewn gastro-jejunal anastomosis slightly larger than for conventional bypass. A RYGB with 50-cm bilio-pancreatic and 150-cm alimentary limb is then performed.
Conclusions: Conversion of Nissen fundoplication to RYGB allows treatment of dysphagia, which may represent a complication of the fundoplication, and is effective for management obesity and GERD. In this video we show important technical steps of this procedure.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s11695-019-04271-y | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Laparoscopic Nissen fundoplication is more cost-effective than open Nissen fundoplication in children.
Pediatr Surg Int
January 2025
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Background: Nissen fundoplication is one of the most common surgical procedures for gastroesophageal reflux. Current and previous research comparing laparoscopic Nissen fundoplication (LNF) versus open Nissen fundoplication (ONF) in children suggest ambiguous conclusions. The purpose of this retrospective study was to compare the outcome for children operated with LNF or ONF at our institution and to evaluate the economic aspects.
View Article and Find Full Text PDFA retrospective study assessing RefluxStop surgery for gastroesophageal reflux disease: Clinical outcomes in 79 patients from Germany.
Surg Open Sci
January 2025
Klinikum Friedrichshafen GmbH, Department of Visceral Surgery, Röntgenstraße 2, 88048 Friedrichshafen, Germany.
Background: This study reports outcomes of the RefluxStop procedure treating gastroesophageal reflux disease (GERD) in clinical practice at a high-volume regional hospital in Germany.
Methods: A retrospective analysis was conducted on 79 patients with chronic GERD that underwent the RefluxStop procedure, comprising high mediastinal dissection, loose cruroplasty, esophagogastroplication between vagal trunks, and fundus invagination of the RefluxStop implant. The primary outcome was GERD Health-Related Quality-of-Life (GERD-HRQL) score and improvement from baseline.
[Visceral surgery : what's new in 2024].
Rev Med Suisse
January 2025
Service de chirurgie viscérale, Département de chirurgie, Centre hospitalier universitaire vaudois, 1011 Lausanne.
This article highlights some advances in visceral surgery in 2024. In the hepato-pancreato-biliary field, liquid biopsies, immunotherapy, and robotics have revolutionized diagnosis and treatment, while artificial intelligence could enhance planning and operational safety. In endocrine surgery, a more conservative approach is recommended for well-differentiated thyroid cancers.
View Article and Find Full Text PDFComparison of Partial Endoscopic vs Surgical Fundoplication after Hiatal Hernia Repair.
J Am Coll Surg
January 2025
Prisma Health Upstate Department of Surgery, Greenville, SC.
Background: The concomitant hiatal hernia repair with endoscopic fundoplication (c-TIF) is a novel anti-reflux procedure that addresses the hiatus and the gastro-esophageal flap valve for surgical candidates with GERD. We aim to compare the outcomes of a hiatal hernia repair with endoscopic fundoplication (TIF) vs surgical partial fundoplication (anterior and posterior) with regards to quality-of-life scores at 12 months after surgery.
Study Design: Following IRB approval, a prospectively maintained anti-reflux database was retrospectively reviewed to identify patients who underwent a c-TIF procedure or a surgical hiatal hernia repair with partial fundoplication.
Economic evaluation of proton pump inhibitors in patients with gastro-oesophageal reflux disease: a systematic review.
BMJ Open Gastroenterol
December 2024
Department of English Language, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
Objectives: Our aim was to systematically review the cost-effectiveness of proton pump inhibitor (PPI) therapies and surgical interventions for gastro-oesophageal reflux disease (GORD).
Design: The study design was a systematic review of economic evaluations.
Data Sources: We searched PubMed, Embase, Scopus, and Web of Science for publications from January 1990 to March 2023.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!