Abdominal Key

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…

Fig. 7.1 The clasp and sling muscle fibers that make up the lower esophageal reflux barrier in the contracted and relaxed state Fig. 7.2 The EndoFlip (Crospon, Cork, Ireland) is…

Operation Antireflux barrier Decreased acid secretion Bile diversion Weight loss Fundoplication Yes No No No Gastric banding Yes No No Yes Sleeve gastrectomy No Yes No Yes Roux-en-Y gastric bypass…

Fig. 20.1 Example of ineffective esophageal motility, Swallow (Sw) 1–10: Hypotensive contraction (Swallow 1, 4, 6, 7, 8, 9); Failed peristalsis (Swallow 2, 3, 5, 10); Weak peristalsis with small…

Fig. 2.1 Anatomy and histology in normal and increasing severity of chronic reflux disease. (a) In the normal patient, the esophagus is lined by squamous epithelium (gray) and the stomach…

Fig. 6.1 Comparison of gastroesophageal and anorectal junctions. When the anorectal junction is graphically rotated (middle image), note the similarity in conformations of the rectum and the esophagus/stomach. In both…

Lifestyle modification Evidence of strength Reasonable to recommend? Sleep with head elevated Equivocal Not generally Avoid fatty meals Equivocal Not generally Avoid carbonated beverages Moderate Yes Select decaffeinated beverages Equivocal…