Pathophysiology of Obesity
Fig. 2.1 The hypothesis of a role of the gut in the pathophysiology of obesity and diabetes. A dysfunctional intestinal signal is posited to be involved in the pathophysiology of…
Surgical Anatomy of the Esophageal Hiatus
Fig. 1.1 The clasp and sling muscle fibers that make up the lower esophageal reflux barrier in the contracted and relaxed state Fig. 1.2 The anatomic relationship of the gastroesophageal…
Reoperative Antireflux Surgery
Surgical fundoplication 360° Fundoplication (Nissen Fundoplication) 180° Posterior fundoplication (Toupet Fundoplication) 180° Anterior fundoplication (Dor Fundoplication) Posterior gastropexy (Hill Procedure) Transthoracic posterior plication (Belsey Procedure) Endoluminal procedures Radiofrequency application to…
Preoperative Evaluation and Testing for GERD
Fig. 8.1 Barium swallow radiographs can be the first indication of an esophageal motility disorder as seen here in this classic corkscrew appearance of diffuse esophageal spasm Hiatal or Paraesophageal…
The Hill Antireflux Operations Repair and Its Variants
Fig. 13.1 Diagrammatic illustration of the Collarsling Musculature. ©2001 Corinne Sandone. Reproduced with permission of illustrator Hill Repair Technique Our standard positioning is low dorsal lithotomy with both arms out,…
The Use of Mesh in Hiatal Hernia Repair
Fig. 18.1 Laparoscopic hiatal hernia repair with PTFE mesh reinforcement using keyhole configuration Fig. 18.2 Laparoscopic hiatal hernia repair with posterior polypropylene mesh Fig. 18.3 There can be a trade-off…
Paraesophageal Hernia: Indications and Technique
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)…
Anterior Partial Fundoplications: Indications and Technique
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…
Complete Fundoplications: Indications and Technique
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…
The Short Esophagus
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…
