Laparoscopic gastroesophageal resection after mesh migration
Epublication WebSurg.com, Mar 2013;13(03). URL: http://websurg.com/doi/vd01en3874
In this video, we describe a laparoscopic gastroesophageal resection after a mesh migration in a 47-year-old woman diagnosed with a giant paraesophageal hernia. Preoperatively, a barium esophagogram, an upper endoscopy and an esophageal manometry were performed to define the anatomy of the esophagus, stomach and gastroesophageal junction, the esophageal peristalsis and the function of the lower esophageal sphincter (LES) to confirm the diagnosis of paraesophageal hernia. Additionally, a 24-hour pH-monitoring was performed to determine the magnitude of gastroesophageal reflux. Five months after the first operation, the patient presented with fever and dysphagia for solids with a 15 Kg weight loss. She underwent a CT-scan of the thorax and the abdomen, a gastrografin X-ray examination and an upper endoscopy, which showed the presence of a mediastinal fistula secondary to mesh migration. For that reason, the patient received a second surgical treatment consisting in a laparoscopic gastroesophageal resection.