By Jon C. Gould, W. Scott Melvin

ISBN-10: 1416063579

ISBN-13: 9781416063575

The final health care professional used to be first brought to laparoscopy approximately two decades in the past. In those earlier twenty years, there was an evolution within the symptoms, techniques, and results for the surgical procedure of many stipulations and illnesses. the talk concerning the optimum procedure maintains. regardless of all the advances which have been made in the course of the 'evolution of the laparoscopic revolution', there's nonetheless development to be made. This factor will research the background of the minimally invasive surgical method of a number of stipulations, ongoing parts of controversy, and destiny instructions.

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Later, Khaitan and colleagues [37] reported on 25 patients treated laparoscopically, with follow-up in 15 patients at a mean of 25 months. These patients also underwent barium esophagram in addition to symptom analysis. They reported one patient having a recurrent PEH and five patients having migration of the wrap above the diaphragm for a total recurrence rate of 40%. Only two of the patients who had wrap migration were symptomatic and these were managed with proton pump inhibitors, with one patient requiring reoperation.

As expected, the debate often follows the lines of subspecialty. Published series in the thoracic surgery literature are published predominantly by thoracic groups, whereas general surgeons publish the majority of transabdominal series. Reviewing these series, proponents of the thoracic approach tout superior ability to mobilize the esophagus and ease of access to perform a CollisNissen gastroplasty as the main advantages to the thoracic approach [11,17,18]. They typically note a high incidence of short esophagus and report using an esophageal lengthening procedure in 69% to 97% of cases [11,12,25].

The laparoscopic Nissen fundoplication is safe and effective in the long-term management of nearly all patients who have chronic GERD. The Toupet fundoplication may be best used in patients who have impaired esophageal body peristalsis. Endoscopic endoluminal therapy Despite the advances made with the advent of laparoscopy, an ideal treatment for GERD that permanently alleviates symptoms, protects against 952 SMITH esophageal erosion, and prevents malignant progression while minimizing the risk associated with therapy remains elusive.

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Advances and Controversies in Minimally Invasive Surgery, An Issue of Surgical Clinics (The Clinics: Surgery) by Jon C. Gould, W. Scott Melvin


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