BackgroundLaparoscopic anti-reflux surgery (LARS) is now well established as an effective treatment in the management of gastro-oesophageal reflux disease (GORD). Some of the reflux can be severe enough to cause upper respiratory symptoms such as laryngitis, hoarseness, chronic cough. Reflux resulting in aspiration can result in lower respiratory tract illnesses such as asthma and pulmonary […]
Background: Despite the good results reported after laparoscopic fundoplication, failure is still a major problem. Hiatal disruption is one of the common patterns of anatomicalfailure, after primary open or laparoscopic antireflux surgery. To prevent hiatal hernia recurrence some authors recommend the use of prosthetic meshes for reinforcement of the hiatal crura. The aim of the […]
Aims: The aim of this study was to describe the trends in uptake of minimally invasive oesophagectomy in England over last 12 years (1996-2008). Methods: The Hospital Episodes Statistics (HES) database is a record based system that since 1986 has collected patient-level data from all English NHS trusts. We examined HES data between April 1996 […]
INTRODUCTION:Controversy over the management of barrett’s esophagus has been difficult to resolve due to the low incidence of progression to adenocarcinoma. A prospective study comparing thousands of patients with barretts esophagus randomized either into PPI or antireflux surgery group is costly and no likely to be perfomed. This study examined possible clinical outcomes of the […]
Introduction: Commonest type of Gastro esophageal junction growth in our region is type III with involvement of the cardia. After resection with adequate margin, the length of the stomach tube might not reach the neck. In such situations Ivor-Lewis Esophago- Gastrectomy with intra thoracic anastamosis is a good alternative. Methods: A retrospective analysis of 13 […]
Introduction: The growing evidence has verified the survival benefit of combined treatment of the chemotherapy followed by the surgery for advanced thoracic esophageal cancer. The endoscopic surgery for thoracic esophageal cancer has been shown to facilitate the early resumption of daily activity of the patients in the postoperative course, but is considered technically difficult especially […]
BACKGROUND: Gastroesophageal reflux disease (GERD) is a common condition in communities in the United States, but treatment options are limited for patients with inadequately controlled symptoms despite high doses of proton-pump inhibitors (PPIs) and who are afraid of surgery. AIM: To determine the outcomes of transoral incisionless fundoplication (TIF) using the EsophyX device in a […]
Objective: We hypothesize that minimally invasive pyloroplasty provides subjective and objective improvement in gastroparesis in patients without secondary GERD. Gastroparesis is a chronic digestive disorder leading to severe and life altering nausea, vomiting, bloating and abdominal pain. Improvements in gastric emptying scintigraphy (GES) times have previously been correlated with symptom improvement. Surgeons are increasingly asked […]
Introduction: Duplication of the alimentary tract is an uncommon occurrence (1 of 4500 births) in pediatric patients and can affect any portion of the gastrointestinal track. The esophagus and ileum are most common site, and gastric duplication cysts represent 4-8% of all alimentary track. Symptoms often occur by 2 years and can include nausea, vomiting, […]
Introduction: Currently, minimally invasive esophagectomy (MIE) is being performed using Video-Assisted Thoracoscopic Surgery (VATS) for mediastinal esophageal dissection. The VATS approach is still associated with pulmonary and cardiovascular morbidity, as well as incisional pain. This study investigates the feasibility of MIE using a single-incision transcervical videoscopic esophageal dissection (TVED). A simultaneous laparoscopic and transcervical videoscopic […]
Introduction:The purpose of this study is to determine if the subjective sensation of dysphagia can be objectively characterized using esophageal function testing.Dysphagia is one of the most difficult symptoms to diagnose and to treat unless a patient has achalasia. Esophageal function testing (EFT) now combines standard manometry, which measures pressures in the esophagus, with multichannel […]
Background: Laparoscopic repair of paraesophageal hernias (PEH) has been extensively studied, as has primary and redo fundoplications. However, very little data are published regarding laparoscopic management of recurrent PEH. We sought to evaluate our institution’s experience with laparoscopic repair of recurrent PEH. Methods: We performed a retrospective review of the Johns Hopkins Medical Institutions’ administrative […]
We would like to present this innovative technique that the author has developed at our centre. In Totally Supine Laparoscopic/Thoracoscopic oesophagectomy we position the patient in Lloyed Davies position and the right arm is elevated in flexion/abduction position. The abdominal phase is performed with standard five port laparoscopic technique followed by the right thoracoscopic mobilisation. […]
Introduction: Although Heller´s myotomy has proven to be the best treatment for patients with Achalasia, the addition of an antireflux procedure is still debatable. The aim of the study is to analyze the impact of the Heller myotomy without an antireflux procedure on postoperative gastroesophageal reflux and LES pressure in patients with Achalasia.Methods: From a […]
Laparoscopy assisted distal gastrectomy (LADG) is widely accepted as a new standard surgical treatment for early gastric cancer. However, LADG is a difficult operation with long learning curve. A training program for LADG was still premature. A beginner surgeon made a great effort for starting this surgery at inexperienced institute. Lecture video or text book […]
Introduction: Laparo-Endoscopic Single Site (LESS) surgery is beginning to include advanced laparoscopic operations, such as Heller myotomy with anterior fundoplication. However, the feasibility and efficacy of LESS Heller myotomy and anterior fundoplication has not been established. This study was undertaken to evaluate our initial experience with LESS Heller myotomy and anterior fundoplication for achalasia. Methods: […]
Aims Laparoscopic surgery is well established for more than 20 years. Laparoscopic antireflux surgery is well accepted world wide and is prformed for many patients suffering from GERD. Some endoscopic treatments were tried in the past but the results have been less than satisfactory. Currently GERD is managed with operations performed laparoscopically with four or […]
Introduction: Patients undergoing laparoscopic paraesophageal herniorraphy, either initial or recurrent, present with a myriad of esophageal and extra-esophageal symptoms. Given an overall recurrence rate of approximately 8%, reoperative paraesophageal herniorraphy is necessary on a significant number of patients. The goal of this study is to determine whether patients proceeding with laparoscopic reoperative paraesophageal herniorraphy experienced […]
INTRODUCTION: Recent studies have shown laparoscopic esophagomyotomy with fundoplication (LM) to have superior long-term symptom relief and low rates of post-operative gastroesophageal reflux when compared to endoscopic dilation (ED). This study evaluates the morbidity, mortality and cost of treating achalasia with LM versus ED.METHODS: The University HealthSystem Consortium (UHC) is an alliance of more than […]
Aims Oesophageal carcinoma is an aggressive disease and not all patients are suitable for surgery. In those selected patients who are considered fit for a surgical procedure, the aim is to perform a radical operation to achieve clearance of both the primary tumour and involved lymph nodes. The surgery is technically challenging and we are […]
Minimally invasive esophagectomy in a patient with portal hypertension. Scott J. Keckler MD, Colleen S. Hupp DO, Amit K. Taggar MD, Mazin F. Al-kasspooles MD, Niazy M. Selim MD, MBChB, PhD. University of Kansas Medical Center, Department of Surgery. Kansas City, KS USA. Introduction: Open surgical resection for esophageal cancer has a high morbidity. As […]
The goal of surgical resection of gastric gastrointestinal stromal tumor (GIST) is to achieve a negative pathologic surgical margin while limiting morbidity. In most cases, nonanatomic wedge resections are sufficient. Laparoscopic surgery is an acceptable option as long as standard oncologic principles are followed, with multiple case series demonstrating similar oncological outcomes as open resection. […]
Introduction: Gastroduodenal intussusception is a rare condition. Fewer than 80 cases have been reported in the literature. Usually, a gastric mass acts as a lead point of the intussuception. Both benign and malignant tumors have been implicated as potential lead points. Case Presentation: A 79 year-old female presented to the ER with dysphagia and epigastric […]
Background. Laparoscopic surgery has limited application in the surgical management of gastric neoplasms, worldwide. In our department the laparoscopic approach is used mainly for staging of gastric neoplasms, but also with curative intent in selected cases. Material and Methods During the last two years we performed: i) 10 laparoscopies for staging of gastric adenocarcinoma, ii) […]