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Videolaparoscopy in the treatment of esophageal reflux disease

The aim of this study is to show the effectiveness of videolaparoscopic fundoplication as the definitive treatment of GERD. From April 1996 to April 1999, 30 patients underwent fundoplication and hiatoplasty for the treatment of reflux esophagitis through videolaparoscopy. Sixteen (53%) were males and 14 (46%) females. The mean age was 44.1, ranging from 3 to 70 years old. Indications for surgery were refractory GERD after prolonged clinical treatment and paraesophageal hernia with hemorrhage (0.3%). Five trocars were employed for each surgical procedure. Hiatoplasty was performed with 00 cotton sutures, wrapping with a X both arms of the diaphragmatic pillars. For fundoplication, after the tranposition of the gastric fundus behind the abdominal portion of the esophagus, an inicial suture was set on the two gastric extremities of the anterior wall, without passing through the esophagus. Then, another 2 or 3 sutures, now including the esophagus, completing the valve. There was no mortality, convertion or complications inherent to the method. We conclude that videolaparoscopic fundoplication is a safe procedure for the definitive treatment of GERD, and provides the advantages of a simple surgical technique, with a low incidence of complications.

Disease by esophagic reflux; Gastroesophagic reflux; Esophagite by reflux; Inferior esophagic esfincter; Laparoscopy


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