A 39-year-old Caucasian male, who had suffered since the age of 19 years from gastroesophageal reflux disease and had undergone laparoscopic Nissen fundoplication with initial resolution of his complaints four years earlier, presented with worsening of heartburn and a new onset of dysphagia. Endoscopy detected an ulcerated fistula orifice on the z-line. Retrograde vision revealed intact Nissen ...

BACKGROUND Surgery for failed antireflux procedures is technically more demanding than primary fundoplication. The success rate does not equal that of the primary procedures. This retrospective analysis aimed to assess long-term subjective and objective outcomes in patients who underwent laparoscopic surgery for fundoplication failure. METHODS Objective and subjective outcomes were assessed b...

UNLABELLED Gastroesophageal reflux disease is common. Fundoplication is very effective for those patients who fail medical therapy, particularly those with an incompetent lower esophageal sphincter. Open surgery is reported to achieve cure rates in excess of 90 percent. Laparoscopic fundoplication has been performed since 1991. The early experience with this procedure is reviewed. RESULTS 199...

Jehovah's Witness patients pose a unique surgical challenge due to their refusal of transfusion of whole blood or major blood products. One of the surgical strategies is to offer the least invasive approach with the least likelihood of losing blood. In the context of surgical treatment of gastroesophageal reflux disease, endoluminal approaches such as transoral incisionless fundoplication repre...

BACKGROUND Since the performance of the first laparoscopic cardiomyotomy for achalasia cardia in 1991, the popularity of the minimally invasive approach for this troublesome disease has been growing. We present our experience of 226 patients who underwent laparoscopic cardiomyotomy and discuss the relevant issues. METHODS A retrospective analysis was carried out of 226 patients who have under...

OBJECTIVE To evaluate the prevalence and possible contributing factors to postprandial bloating in patients having chronic gastroesophageal reflux disease (GERD) before and after laparoscopic Nissen fundoplication. DESIGN A prospective cohort study. SETTING A tertiary care teaching hospital. PATIENTS Five hundred and seventy-eight patients with proven GERD. INTERVENTION Laparoscopic Nis...

BACKGROUND We recently implemented the use of an ex-vivo porcine model to teach residents the fundamentals of performing a laparoscopic Nissen fundoplication. METHODS Residents were trained using intact porcine esophagus, stomach, and spleen placed in a standard video-trainer. They were later asked to complete a survey containing a course evaluation. RESULTS Sixteen residents (R1-R4) comple...