We use cookies to offer you an optimal experience on our website. By browsing our website, you accept the use of cookies.
Filter by
Specialty
View more
Clear filter Media type
View more
Clear filter Category
View more
Publication date
Sort by:
Laparoscopic pyloroplasty for gastroparesis after Nissen fundoplication
Authors demonstrate the management of laparoscopic pyloroplasty in a diabetic female patient presenting with severe gastroparesis after Nissen fundoplication. Gastroparesis is often known to be caused by a vagal nerve lesion during fundoplication, and can be improved by diabetes mellitus. If medical treatment is unsuccessful, a surgical approach is mandatory. Various techniques are described such as pyloroplasty, gastroenterostomy or gastric neurostimulation. We chose the procedure with minimal complications and best postoperative quality of life results as the first-line surgical treatment, namely laparoscopic pyloroplasty.
D Mutter, HA Mercoli, J Marescaux
Surgical intervention
4 years ago
2168 views
47 likes
0 comments
07:06
Laparoscopic pyloroplasty for gastroparesis after Nissen fundoplication
Authors demonstrate the management of laparoscopic pyloroplasty in a diabetic female patient presenting with severe gastroparesis after Nissen fundoplication. Gastroparesis is often known to be caused by a vagal nerve lesion during fundoplication, and can be improved by diabetes mellitus. If medical treatment is unsuccessful, a surgical approach is mandatory. Various techniques are described such as pyloroplasty, gastroenterostomy or gastric neurostimulation. We chose the procedure with minimal complications and best postoperative quality of life results as the first-line surgical treatment, namely laparoscopic pyloroplasty.
Laparoscopic gastric pacing
We present the case of a 38-year-old woman with intractable gastroparesis. Her background history was significant for type I diabetes mellitus (DM), a pancreas kidney transplant in 2006, Nissen fundoplication, gastrotomy for bleeding Dieulafoy’s lesion, diabetic retinopathy, peripheral vascular disease, and gastroparesis which was diagnosed in 2007. She complained of daily vomiting, early satiety, abdominal discomfort, nocturnal diarrhea, and significant weight loss. In addition, she had required multiple hospital admissions with severe electrolyte derangement and repeat OGDs. Her symptoms were refractory to motility agents and to Botox therapy. Following a multidisciplinary discussion, she was offered a gastric stimulator. We present a laparoscopic approach to gastric stimulator insertion. The device that we use is the Medtronic Enterra® therapy system. The patient was discharged well after 48 hours. At a follow-up of 4 weeks, her symptoms had improved significantly: her vomiting had reduced to once per week, and she no longer suffered from nocturnal diarrhea. At a follow-up of 3 months, her vomiting had ceased completely and she was gaining weight. The patient returned to work and to normal daily activities.
D Joyce, S Patchett, D Hickey, M Arumugasamy
Surgical intervention
5 years ago
1216 views
33 likes
0 comments
07:01
Laparoscopic gastric pacing
We present the case of a 38-year-old woman with intractable gastroparesis. Her background history was significant for type I diabetes mellitus (DM), a pancreas kidney transplant in 2006, Nissen fundoplication, gastrotomy for bleeding Dieulafoy’s lesion, diabetic retinopathy, peripheral vascular disease, and gastroparesis which was diagnosed in 2007. She complained of daily vomiting, early satiety, abdominal discomfort, nocturnal diarrhea, and significant weight loss. In addition, she had required multiple hospital admissions with severe electrolyte derangement and repeat OGDs. Her symptoms were refractory to motility agents and to Botox therapy. Following a multidisciplinary discussion, she was offered a gastric stimulator. We present a laparoscopic approach to gastric stimulator insertion. The device that we use is the Medtronic Enterra® therapy system. The patient was discharged well after 48 hours. At a follow-up of 4 weeks, her symptoms had improved significantly: her vomiting had reduced to once per week, and she no longer suffered from nocturnal diarrhea. At a follow-up of 3 months, her vomiting had ceased completely and she was gaining weight. The patient returned to work and to normal daily activities.