Fig. 12.1 Annual volumes of paraesophageal hernia operations in a single academic practice Hiatal hernias are classified as five types based on the relative position of the gastroesophageal junction (GEJ)…
Fig. 11.1 Selection of the correct piece of anterior fundus for anterior 180° partial fundoplication. The assistant pulls the gastro-esophageal junction downwards. The correct piece of fundus is usually closer…
Fig. 9.1 Original case report published by Rudolf Nissen in 1956. “Rudolf Nissen (1896–1981)-Perspective” (from Journal of Gastrointestinal Surgery) It was discovered early on that the proper function of a…
Authors Indication Total number Requiring a lengthening procedure (%) Type of lengthening procedure Madan et. al [3] GERD 628 0 None Bochkarev et al. [2] GERD 106 0 None Swanstrom…
Fig. 21.1 Various evaluation and treatment algorithms for patients presenting with (a) primarily GERD or (b) primarily gastroparesis symptoms There have been studies in the adult and pediatric populations that…
Fig. 10.1 Creation of Toupet fundoplication with key posterior gastropexy sutures and right fundoplication sutures to the esophagus. Left sided esophagopexy fundoplication sutures not shown Various types of partial fundoplications…
Open 1986a (%) Lap 1998b (%) Lap 2006c (%) Lap 2011d (%) Inability to belch 36 20 – – Inability to vomit (if tried) 63 25 – – Increased…
Indications Potential indications Abnormal pH testing (positive DeMeester score) Refractory GERD to surgical therapy (failed surgical treatment) PPI-responsive typical GERD symptoms Atypical GERD symptoms Small hiatal hernia (<2 cm) Mild…
Complication Early Late Death 0.09 0.001 Conversion to open 0–10 % Reoperation <0.1 % 3–10 % Side effects (dysphagia, bloating, nausea, etc.) 20–60 % 5–10 % The rate of conversion…
Fig. 17.1 Avoidance of dissection injury of the gastroesophageal junction requires careful retraction, identification of critical structures, precise dissection, and careful use of energy. An angled laparoscope allows dissection behind…
