title: Esophagogastric fistula secondary to teflon pledget: a rare complication following laparoscopic fundoplication.
abstract: Laparoscopic fundoplication has become the standard operation for gastroesophageal reflux disease. In our service, a laparoscopic fundoplication is performed as a 2-cm floppy 360 degrees wrap with division of the short gastric vessels and the fundoplication is sutured using a prolene 2/0 mattress suture (Ethicon, USA) and buttressed laterally with two teflon pledgets (PTFE 1.85 mm; low porosity, Bard, USA). We report a patient with post-operative dysphagia due to an esophagogastric fistula caused by erosion of a teflon pledget. This is the first such case in 734 laparoscopic fundoplications performed between January 1991 and December 1998. Reoperation was required, resulting in a prolonged convalescence. A review of current literature has not revealed any similar cases. Causes for this rare complication are postulated.
authors.affiliation: Department of Surgery, Alexandra Hospital, Singapore, Singapore.
authors.forename: H G
authors.initials: HG
authors.lastname: Baladas
authors.forename: G S
authors.initials: GS
authors.lastname: Smith
authors.forename: M A
authors.initials: MA
authors.lastname: Richardson
authors.forename: M B
authors.initials: MB
authors.lastname: Dempsey
authors.forename: G L
authors.initials: GL
authors.lastname: Falk
mesh_terms: D004937:Esophageal Fistula / Q000175:diagnosis*; D018662:Fundoplication / Q000379:methods; D005747:Gastric Fistula / Q000175:diagnosis*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*