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Bell R. Is systematic formal crural repair mandatory at the time of magnetic sphincter augmentation implantation? Dis Esophagus 2023:6972914. [PMID: 36617229 DOI: 10.1093/dote/doac108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/21/2022] [Accepted: 12/06/2022] [Indexed: 01/09/2023]
Abstract
Laparoscopic placement of the LINX Magnetic Sphincter Augmentation (MSA) device has become an accepted alternative to fundoplication in appropriate patients. Initial studies of MSA targeted to patients with 'early' disease allowed for the most minimal dissection of the esophagus to place the device, without hiatal dissection or repair (NoHHR), in patients with no or minimal hernia findings at surgery. Subsequent studies have compared systematic formal hiatal dissection and repair (Formal HHR) with the original minimal dissection technique. Review of published literature on MSA includes discussion on treatment of hiatal hernia at the time of implantation, accompanying the review of the physiology of the crural diaphragm. Formal hiatal hernia repair at the time of MSA implantation results in better control of reflux with less dysphagia and risk of postoperative hernia than NoHHR, regardless of the presence or size of hiatal hernia. Systematic crural repair should accompany any MSA implantation regardless of the presence or size of hiatal hernia.
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Affiliation(s)
- Reginald Bell
- Institute of Esophageal and Reflux Surgery, Lone Tree, CO80124, USA
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Manrique-Mendoza AR, González-Muñoz A, Reyes Ó, González JR. Herniorrafia hiatal y fundoplicatura laparoscópica de Toupet en un paciente con esófago corto. REVISTA COLOMBIANA DE CIRUGÍA 2019. [DOI: 10.30944/20117582.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
El esófago corto es una complicación infrecuente del reflujo gastroesofágico, polémico para algunos autores. Su diagnóstico se hace de manera intraoperatoria, ante la imposibilidad de conservar un esofago intrabdominal mayor a tres centímetros desde el hiato diafragmático. Algunos expertos niegan la existencia de esta entidad, argumentando que se debe a una mala disección del esófago.
En este artículo, se presenta el caso de un paciente sometido a herniorrafia hiatal con colocación de malla, con gran dificultad para conservar una adecuada longitud del esófago abdominal, y que no requirió gastroplastia.
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Radovanovic D, Pavlovic M, Canovic D, Lazic D, Cvetkovic A, Spasic M, Stojanovic B, Milosevic B. The Collis Procedure and the Acquired Short Esophagus. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2019. [DOI: 10.1515/sjecr-2016-0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
One of the most intriguing problems in modern esophageal surgery is the acquired short esophagus. While some authors recognize this entity, others deny its existence. There is a consensus about types of the short esophagus, its etiology and pathophysiology. Definitive diagnosis can be established only intraoperatively. There are a few surgical procedures for this problem, and most frequently is used Collis gastroplasty with fundoplication. In this review we emphasize recent literature data and further perspectives of the Collis procedure.
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Affiliation(s)
- Dragce Radovanovic
- Clinic for general and thoracic surgery , Clinical center Kragujevac , Kragujevac , Serbia
- University of Kragujevac , Faculty of Medical Sciences , Kragujevac , Serbia
| | - Mladen Pavlovic
- Clinic for general and thoracic surgery , Clinical center Kragujevac , Kragujevac , Serbia
- University of Kragujevac , Faculty of Medical Sciences , Kragujevac , Serbia
| | - Dragan Canovic
- Clinic for general and thoracic surgery , Clinical center Kragujevac , Kragujevac , Serbia
- University of Kragujevac , Faculty of Medical Sciences , Kragujevac , Serbia
| | - Dejan Lazic
- Clinic for general and thoracic surgery , Clinical center Kragujevac , Kragujevac , Serbia
- University of Kragujevac , Faculty of Medical Sciences , Kragujevac , Serbia
| | - Aleksandar Cvetkovic
- Clinic for general and thoracic surgery , Clinical center Kragujevac , Kragujevac , Serbia
- University of Kragujevac , Faculty of Medical Sciences , Kragujevac , Serbia
| | - Marko Spasic
- Clinic for general and thoracic surgery , Clinical center Kragujevac , Kragujevac , Serbia
- University of Kragujevac , Faculty of Medical Sciences , Kragujevac , Serbia
| | - Bojan Stojanovic
- Clinic for general and thoracic surgery , Clinical center Kragujevac , Kragujevac , Serbia
- University of Kragujevac , Faculty of Medical Sciences , Kragujevac , Serbia
| | - Bojan Milosevic
- Clinic for general and thoracic surgery , Clinical center Kragujevac , Kragujevac , Serbia
- University of Kragujevac , Faculty of Medical Sciences , Kragujevac , Serbia
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