title: Laparoscopic Toupet's fundoplication in children.
abstract: Laparoscopic fundoplication is performed commonly in children, and it represents "the gold standard" in children with gastroesophageal reflux disease (GERD) refractory to medical therapy. We present a single surgeon's experience with a posterior partial valve. Between May 1993 and May 2002, we operated on 574 children using Toupet's procedure. Among the patients, 24 were younger than 1 year of age, and 17 others were neurologically impaired. The average duration of the surgery was 1 hour. Complications were limited to 3 eviscerations of omentum through the port wounds. Relapse of GERD secondary to valve failure occurred in 6 patients, 1 neurologically impaired and 1 with mucoviscidosis. All six patients have been reoperated on laparoscopically, and Toupet fundoplication was performed again with good results. We think that the 270-degree posterior valve, according to Toupet, is a good procedure to adopt in children with GERD with a low rate of recurrence at long-term follow-up.
authors.affiliation: Pediatric Surgery Unit, Bicetre Hospital, Paris, France. philippe.montupet@wanadoo.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Montupet
mesh_terms: D002648:Child; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D011028:Pneumoperitoneum, Artificial; D012086:Reoperation; D016896:Treatment Outcome