1. Is GERD truly present and validated by endoscopy and/or pH monitoring? 2. Does GERD affect the patient’s quality of life? 3. Is there a confounding illness that makes GERD…
Type Location of GEJ Incidence Symptoms I Above diaphragmatic hiatus >90% Asymptomatic or GERD II Normal anatomic position <1% Asymptomatic but may become strangulated or incarcerated III Above diaphragmatic 5%…
Fig. 17.1 Gastrographin swallow demonstrating an acute postoperative paraesophageal herniation Fig. 17.2 Slipped fundoplication A correlation between the cause of recurrence and the interval between the primary procedure and the…
Tension Radial Axial Technical Misplaced wrap Incomplete hiatal dissection Misidentified GEJ Loose sutures Improperly tied knots Poor tissue bites Surgeon experience Asymmetric fundoplication Tightness of fundoplication Tightness of crural closure…
VAS (visual analog scale ) of patient satisfaction with symptom control score range from 0 (no relief) to 100 (complete symptom relief), more than 70 equals symptom control De Mester…
Fig. 9.1 Large PHH The current chapter will address an area of controversy i.e., the use of prosthetic material (mesh) at the esophageal hiatus and whenever possible will compare it…
Slipped fundoplication and hiatal hernia Slipped fundoplication Malpositioned fundoplication Malpositioned fundoplication and hiatal hernia Tight fundoplication Hiatal hernia alone Loose fundoplication Tight cruroplasty 13.2 Pathophysiology Despite having been recognized over…
Typical Atypical Heartburn Hoarseness Regurgitation Throat pain Chest pain Globus sensation Water brash Cough Dysphagia Shortness of breath Belching Asthma Bloating 5.3.1 Atypical Symptoms Atypical or extraesophageal symptoms of GERD…
Fig. 10.1 The anatomy of the normal esophago-gastric junction showing the esophagus, stomach, diaphragm and the clasp and sling fibers (modified and reproduced with permission from ref. [2]) LES is…
Fig. 3.1 Schematic representation of the gastroesophageal junction (GEJ) In health, the lower esophageal sphincter (LES) is approximately 4 cm long extending from just above the squamo-columnar junction (Z-line) into…
