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laparoscopic anti-reflux procedures

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Traditional fundoplication to treat oesophageal reflux has been carried out laparoscopically via an abdominal approach. An alternative is the laparoscopic use of a mobilised falciform ligament to wrap around the oesophagus: a ligamentum teres cardiopexy. Both techniques are still not widely established, but they offer considerable advantage to the patient, e.g. decreased pain and increased cosmesis.

Indications for laparoscopic anti-reflux procedures include:

  • intractable oesophagitis
  • failure of medical therapy
  • onset of complications, e.g. Barrett's oesophagus
  • chronic anaemia

Contraindications include:

  • prior vagotomy or partial gastrectomy
  • an enlarged left lobe of the liver as the laparoscopic field of view is reduced
  • oesophageal shortening

Potential complications include injury to any of the organs in the vicinity, pneumothorax and 'gas bloat syndrome' due to excessive constriction of the oesophagus.


General Practice Notebook
General Practice Notebook
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