Collis Nissen for slipped fundoplication with recurrent GERD symptoms
Epublication WebSurg.com, Jan 2010;10(01). URL: http://websurg.com/doi/vd01en2810
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.