Novel technique for retraction of the gastroesophageal junction in laparoscopic antireflux surgery.
Laparoscopic antireflux surgery is a recognized procedure for patients diagnosed with gastroesophageal reflux disease whose symptoms are refractory to medical treatment. We describe a novel and cost-effective technique that aids in mobilization and retraction of the gastroesophageal junction before repair of the diaphragmatic crural defect. After hiatal dissection and creation of a posterior gastric wrap, an index suture (2-0 ethibond) is placed across the wrap. This is used to retract the gastroesophageal junction and expose the crura for repair and "required facilitate fixation of fundus to the crura (fundopexy)." This technique negates the requirement for further instruments thus reducing operative expenditure and offers minimal disruption to the tissue. We have performed over 350 operative procedures using this technique and recommend it as an alternative choice that is cost effective for retraction of the esophagogastric junction in antireflux surgery.
James Cook University Hospital, Middlesbrough, UK.
Anantha
A
Madhavan
Karthik
K
Maruthachalam
Yirupaiahgari Krishnaiah Setty
YK
Viswanath
D003362:Cost-Benefit Analysis; D004943:Esophagogastric Junction / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000191:economics / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000191:economics / Q000379:methods*; D013536:Suture Techniques / Q000191:economics