General operative considerations Mobilization Incision of gastrohepatic ligament Incision of phrenoesophageal membrane Dissection of right crus away from gastroesophageal junctiona Division of short gastric vessels and exposure of left crus…
Fig. 12.1 Computed tomographic scan in a patient with chest herniation of a Nissen fundoplication Indications to reoperation should be based on the patient’s physiological state, the severity of symptoms,…
Fig. 8.1 (a) Normal endoscopic appearance of an intact Nissen fundoplication on retroflexion view. The entire valve body is located below the crural diphragm, confirming its intra-abdominal location. It conceals…
Normal pHmonitoring Extra-esophageal symptoms Lack of response to acid suppression therapy Psychiatric disorders Obesity Female gender Absence of hiatal hernia Low socioeconomic status Since diverse symptoms respond differently to antireflux…
Fig. 11.1 Retroflexion view in stomach of normal fundoplication appearance. With sufficient insufflation careful assessment should be made of features of wrap folds’ position (below the z-line and diaphragm), length…
Resolution of heartburn Resolution of extraesophageal symptoms Group 1 – Severe heartburn/Minimal extraesophageal symptoms 87% – Group 2 – Severe heartburn/Severe extraesophageal symptoms 76% 42% Group 3 – Minimal…
Source Sample size Intervention Primary outcomes Main findings P-value Cough Shaheen 2011 40 Esomeprazole 40 mg bid for 12 weeks versus placebo Change in Cough Specific Quality of Life Questionnaire…
Fig. 2.1 Recommended pathway for GERD evaluation and management (GERD gastroesophageal reflux disease, PPI proton-pump inhibitor, HREM high resolution esophageal manometry, MII-pH multichannel intraluminal impedance and pH) Of course, not…
Fig. 3.1 Approach to medical management of GERD symptoms (GERD Gastroesophageal reflux disease, PPI Proton-pump inhibitor, EGD Esophagogastroduodenoscopy, BID Twice daily, H2RA QHS H2-receptor antagonist every evening, as applied to…
© Springer International Publishing AG 2017P. Marco Fisichella (ed.)Failed Anti-Reflux Therapy10.1007/978-3-319-46885-3_9 9. Technical Surgical Failures: Presentation, Etiology, and Evaluation Chase Knickerbocker1, Devendra Joshi1 and Kfir Ben-David1 (1) Mount Sinai Medical Center, Comprehensive Cancer Center, 4306 Alton Road,…
