title: Surgical approach after failed enteryx injection for GERD.
abstract: OBJECTIVE
  We report on 3 patients who underwent laparoscopic antireflux procedures for persistent symptoms of GERD after biopolymer injection.
  
  
  METHODS
  Experienced laparoscopic surgeons completed all 3 procedures laparoscopically. In 2 patients, there was an extramural extravasation of the polymer outside and adherent to the esophageal wall. In these patients, a partial posterior fundoplication was used. The third patient, who had the polymer material deposits removed preoperatively by endoscopic mucosal resection, underwent a Nissen fundoplication.
  
  
  RESULTS
  Postoperative recovery was uneventful in all cases. At follow-up of 6 to 12 months, all patients were symptom free, off medical therapy, and experiencing no dysphagia.
  
  
  CONCLUSIONS
  Surgical therapy for patients after failed biopolymer injection is safe and effective. The choice of surgery may depend on whether the polymer mass can be removed preoperatively.
authors.affiliation: IRCAD/European Institute of Telesurgery, Louis Pasteur University, Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Alzahrani
authors.forename: M
authors.initials: M
authors.lastname: Anvari
authors.forename: B
authors.initials: B
authors.lastname: Dallemagne
authors.forename: D
authors.initials: D
authors.lastname: Mutter
authors.forename: J
authors.initials: J
authors.lastname: Marescaux
mesh_terms: D000328:Adult; D005764:Gastroesophageal Reflux / Q000601:surgery / Q000628:therapy*; D005773:Gastroscopy; D006801:Humans; D007267:Injections; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D011145:Polyvinyls / Q000008:administration & dosage* / Q000009:adverse effects; D012008:Recurrence; D017211:Treatment Failure
chemical_list: D011145:Polyvinyls; C020320:ethylene-vinyl alcohol copolymer