Document Detail

Laparoscopic surgery of the gastroesophageal junction.
MedLine Citation:
PMID:  10030859     Owner:  NLM     Status:  MEDLINE    
Incompetence of the lower esophageal sphincter mechanism leads to gastroesophageal reflux (GER), which is the most common indication for surgery of the gastroesophageal junction. Evaluation, diagnosis, and the modern surgical treatment of GER are discussed. Evaluation of patients with severe heartburn include upper endoscopy to evaluate the general condition of the esophagus, stomach, and duodenum; an upper gastrointestinal contrast study for a complete anatomic view of the esophagus and stomach; esophageal manometry to evaluate the function of the esophagus; 24-hour pH monitoring to determine esophageal acid exposure; and a gastric emptying study selectively to determine the presence of a motility disorder. These studies most often prove the diagnosis of gastroesophageal reflux, hiatal hernia, Barrett's esophagus, peptic esophageal stricture, paraesophageal hernia, or achalasia. The laparoscopic approach to treatments for these include Nissen fundoplication, Toupet fundoplication, Collis gastroplasty with fundoplication, modified Heller myotomy, esophageal diverticulectomy, and revisional operations. These procedures are described in detail. The results of these operations indicate that they are safe and effective and should be considered the new gold standard for correction of gastroesophageal pathology. Laparoscopic surgery has revolutionized many procedures traditionally performed through a laparotomy. Although they are technically more difficult and require a significant amount of time and practice for the surgeon to become proficient, it is becoming apparent that for functional surgery of the gastroesophageal junction laparoscopy is the access of choice.
H Spivak; S Lelcuk; J G Hunter
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Publication Detail:
Type:  Comparative Study; Journal Article; Review    
Journal Detail:
Title:  World journal of surgery     Volume:  23     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-04-05     Completed Date:  1999-04-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  356-67     Citation Subset:  IM    
Department of Surgery, Rabin Medical Center, Beilinson Campus, Petach-Tikva 49100, Israel.
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MeSH Terms
Endoscopy, Digestive System
Esophageal Diseases / diagnosis,  surgery*
Esophagogastric Junction / surgery*
Follow-Up Studies
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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