title: Upside-down stomach - results of mini-invasive surgical therapy.
abstract: OBJECTIVE
  The authors evaluate the results of mini-invasive therapy in patients diagnosed with upside-down stomach.
  
  
  METHODS
  From 1998 to 2008, a total of 27 patients diagnosed with upside-down stomach were surgically treated at the 1st Department of Surgery, University Hospital Olomouc. Before the operation, patients were examined endoscopically and a barium swallow was performed. In all 27 patients (100%), the operation was performed electively laparoscopically. The principle of the operation in all cases was reposition of the stomach into the abdominal cavity, resection of the hernial sac and hiatoplasty. In addition, in 15 patients (56%) with reflux symptoms or endoscopic findings of reflux oesophagitis, fundoplication in Nissen's modification was also performed. Fundopexy was indicated in 12 patients (44%).
  
  
  RESULTS
  In all patients (100%), the operation was performed mini-invasively; conversion to an open procedure was never necessary. In 3 cases (11%), the left pleural cavity was opened during the operation; this was treated by introducing a chest drain. The operation mortality in the patient set was zero; morbidity was 11%. A year after the operation, patients were re-examined, and follow-up endoscopy and barium swallow were performed.
  
  
  CONCLUSIONS
  In all patients diagnosed with upside-down stomach, surgical treatment is indicated due to the risk of developing severe complications. Mini-invasive surgical therapy in the hands of an experienced surgeon is a safe procedure which offers patients all the benefits of mini-invasive therapy with promising short- and long-term results.
authors.affiliation: 1  Department of Surgery, Palacky University Medical School and Teaching Hospital Olomouc, Czech Republic.
authors.forename: Radek
authors.initials: R
authors.lastname: Vrba
authors.forename: Rene
authors.initials: R
authors.lastname: Aujesky
authors.forename: Katherine
authors.initials: K
authors.lastname: Vomackova
authors.forename: Lenka
authors.initials: L
authors.lastname: Zbrozkova
authors.forename: Cestmir
authors.initials: C
authors.lastname: Neoral