Joseph R Broucek, MD, Enrique Elli, MD, FACS. Mayo Clinic – Florida
Failure rates of laparoscopic Nissen fundoplication occur in the range of 2-17%. The most common recurrent symptoms include reflux and regurgitation. If the patient fails medical therapy, revisional surgery is known to be successful in more than 90% of cases.
This is a case of a 73-year-old female who, previously, had a Nissen fundoplication in 2008 at an outside facility for classic reflux symptoms including bitter/sour taste and regurgitation. She presented to Mayo Clinic with recurrent symptoms of reflux and regurgitation require re-initiation of omeprazole as well as inability to sleep in a recumbent position. Manometry showed weak peristalsis with 80% failed swallows and an IRP of -16.1. Upper GI showed a herniated wrap with stomach slipped through the wrap and into the chest. EGD confirmed a loose wrap and lax lower esophageal sphincter. She was deemed and operative candidate for revision and conversion to Toupet fundoplication due to her weak peristalsis.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95772
Program Number: V068
Presentation Session: Exhibit Hall Theater Video Session II
Presentation Type: EHVideo