Abstract
Background: The short esophagus increases the difficulty and limits the effectiveness of laparoscopic Nissen fundoplication. In our experience, ∼20-25% of esophagi judged by preoperative criteria to be foreshortened will, after dissection, be insufficiently long to allow 2 cm of esophagus to reside below the diaphragm without inferior distraction (i.e., tension free). Collis gastroplasty combined with Nissen fundoplication has become the standard approach for the creation of an intraabdominal neoesophagus and fundic wrap. Methods: After developing methods of performing totally laparoscopic stapled gastroplasty in the cadaver lab in 1994, we started applying the technique clinically in 1996. We performed 220 laparoscopic antireflux procedures between January 1996 and July 1997. Of these 220 patients, 26% were suspected to have esophageal foreshortening based on preoperative barium studies and/or endoscopy. Results: After hiatal dissection. nine patients, or 16% of those suspected to have esophageal foreshortening and 4% of the entire population, required the laparoscopic Collis-Nissen procedure. There was symptomatic improvement in all patients as assessed by patient-initiated symptom scores. Conclusions: The management of patients with esophageal foreshortening is a complex problem. We believe that our technique of laparoscopic Collis-Nissen provides an effective means of achieving intraabdominal placement of the fundic wrap while maintaining the benefits of a minimally invasive approach.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1055-1060 |
| Number of pages | 6 |
| Journal | Surgical Endoscopy and Other Interventional Techniques |
| Volume | 12 |
| Issue number | 8 |
| State | Published - Aug 1998 |
| Externally published | Yes |
Fingerprint
Keywords
- Collis gastroplasty
- Esophageal stricture
- Gastroesophageal junction
- Hiatal hernia
- Laparoscopic Nissen fundoplication
- Paraesophageal hernia
ASJC Scopus subject areas
- Surgery
Cite this
Laparoscopic Collis gastroplasty and Nissen fundoplication : A new technique for the management of esophageal foreshortening. / Johnson, A. B.; Oddsdottir, M.; Hunter, John.
In: Surgical Endoscopy and Other Interventional Techniques, Vol. 12, No. 8, 08.1998, p. 1055-1060.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic Collis gastroplasty and Nissen fundoplication
T2 - A new technique for the management of esophageal foreshortening
AU - Johnson, A. B.
AU - Oddsdottir, M.
AU - Hunter, John
PY - 1998/8
Y1 - 1998/8
N2 - Background: The short esophagus increases the difficulty and limits the effectiveness of laparoscopic Nissen fundoplication. In our experience, ∼20-25% of esophagi judged by preoperative criteria to be foreshortened will, after dissection, be insufficiently long to allow 2 cm of esophagus to reside below the diaphragm without inferior distraction (i.e., tension free). Collis gastroplasty combined with Nissen fundoplication has become the standard approach for the creation of an intraabdominal neoesophagus and fundic wrap. Methods: After developing methods of performing totally laparoscopic stapled gastroplasty in the cadaver lab in 1994, we started applying the technique clinically in 1996. We performed 220 laparoscopic antireflux procedures between January 1996 and July 1997. Of these 220 patients, 26% were suspected to have esophageal foreshortening based on preoperative barium studies and/or endoscopy. Results: After hiatal dissection. nine patients, or 16% of those suspected to have esophageal foreshortening and 4% of the entire population, required the laparoscopic Collis-Nissen procedure. There was symptomatic improvement in all patients as assessed by patient-initiated symptom scores. Conclusions: The management of patients with esophageal foreshortening is a complex problem. We believe that our technique of laparoscopic Collis-Nissen provides an effective means of achieving intraabdominal placement of the fundic wrap while maintaining the benefits of a minimally invasive approach.
AB - Background: The short esophagus increases the difficulty and limits the effectiveness of laparoscopic Nissen fundoplication. In our experience, ∼20-25% of esophagi judged by preoperative criteria to be foreshortened will, after dissection, be insufficiently long to allow 2 cm of esophagus to reside below the diaphragm without inferior distraction (i.e., tension free). Collis gastroplasty combined with Nissen fundoplication has become the standard approach for the creation of an intraabdominal neoesophagus and fundic wrap. Methods: After developing methods of performing totally laparoscopic stapled gastroplasty in the cadaver lab in 1994, we started applying the technique clinically in 1996. We performed 220 laparoscopic antireflux procedures between January 1996 and July 1997. Of these 220 patients, 26% were suspected to have esophageal foreshortening based on preoperative barium studies and/or endoscopy. Results: After hiatal dissection. nine patients, or 16% of those suspected to have esophageal foreshortening and 4% of the entire population, required the laparoscopic Collis-Nissen procedure. There was symptomatic improvement in all patients as assessed by patient-initiated symptom scores. Conclusions: The management of patients with esophageal foreshortening is a complex problem. We believe that our technique of laparoscopic Collis-Nissen provides an effective means of achieving intraabdominal placement of the fundic wrap while maintaining the benefits of a minimally invasive approach.
KW - Collis gastroplasty
KW - Esophageal stricture
KW - Gastroesophageal junction
KW - Hiatal hernia
KW - Laparoscopic Nissen fundoplication
KW - Paraesophageal hernia
UR - http://www.scopus.com/inward/record.url?scp=0032134058&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0032134058&partnerID=8YFLogxK
M3 - Article
C2 - 9685542
AN - SCOPUS:0032134058
VL - 12
SP - 1055
EP - 1060
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
IS - 8
ER -