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Collis Nissen for slipped fundoplication with recurrent GERD symptoms

B Dallemagne, MD J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Jan 2010;10(01). URL: http://websurg.com/doi/vd01en2810

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  • 1889
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  • 2010-01-14
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Hiatal hernia recurrence is a dreaded postoperative complication after surgery for gastroesophageal reflux. This video presents a live surgery performed in a patient presenting with recurrent symptoms and dysphagia after a previous Nissen fundoplication that was performed 5 years ago. All the preoperative work-up demonstrates the recurrent reflux, mixed ascites, and alkaline reflux associated with an intrathoracic migration of the proximal stomach, and probably a slippage of the valve on the upper part of the stomach. This patient has a manometry, which confirmed the weakness of the lower esophageal sphincter (LES) associated with some dysmotility disorders in the lower esophagus.