Paraesophageal Hernias: Indications and Surgical Treatment
Hiatal hernia type Anatomy I The EGJ herniates above the diaphragmatic crura, often moving transiently from the abdomen into the mediastinum II A portion of the stomach is herniated into…
Revisional Surgery for Achalasia
Fig. 17.1 30–40° separation of the myotomy edges 4. Tight closure of the hiatus. Because sutures that narrow the hiatal opening may impair esophageal emptying, we do not advocate…
Endoscopic Management of Achalasia
Achalasia subtype Manometry criteria Type I (classic) Impaired EGJ relaxation (IRP >10 mmHg) Absent peristalsis No significant esophageal pressurization Type II (with compression) Impaired EGJ relaxation (IRP >15 mmHg) Absent…
Treatment of Epiphrenic Diverticula
Fig. 6.1 Position of operative ports and liver retractor (Reprinted with permission) Mobilization of the Distal Esophagus An Allis clamp is inserted through Port D near the gastroesophageal junction to…
Esophageal Anatomy and Physiology for the Surgeon
Fig. 1.1 Layers in the esophageal wall Contrary to the rest of the gastrointestinal tract, the esophagus has no serosal layer. Blood Supply The cervical portion of the esophagus is…
Surgical Treatment of Esophageal Achalasia
Fig. 12.1 Placement of the trocars The instrumentation necessary for the laparoscopic myotomy is reported in Table 12.1. Table 12.1 Instrumentation for laparoscopic Heller myotomy and partial fundoplication Five 10-mm…
Pathophysiology of Gastroesophageal Reflux Disease
Fig. 2.1 Pathophysiological determinants of GERD. GERD is very heterogeneous in presentation encompassing strictly mucosal consequences, typical reflux symptoms, atypical reflux symptoms, and hypersensitivity syndromes. The one thing that all…
The Chicago Classification of Esophageal Motility Disorders
Fig. 3.1 Normal peristalsis in HRM with EPT plots. The esophageal contraction is characterized by three troughs and the contractile deceleration point (CDP, black dot). EGJ relaxation is assessed using…
Barrett’s Esophagus: Treatment Options and Management
Fig. 15.1 Endoscopic view of Barrett’s esophagus epithelium. Endoscopic view of a long segment of columnar epithelium (salmon pink) above the gastroesophageal junction on a background of squamous epithelium (gray)…
Endoscopic Treatment of Gastroesophageal Reflux Disease
Fig. 10.1 EndoCinch. The Bard EndoCinch (C. R. Bard, Inc., Murray Hill, NJ) delivers a hollow-core needle through a suction capsule that acts to pull the tissue at the squamocolumnar…
