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01-03-2010

A simplified technique for intrathoracic stomach repair: laparoscopic fundoplication with Vicryl mesh and BioGlue crural reinforcement

Authors: Jörg Zehetner, John C. Lipham, Shahin Ayazi, Arzu Oezcelik, Emmanuele Abate, Weisheng Chen, Steven R. DeMeester, Helen J. Sohn, Farzaneh Banki, Jeffrey A. Hagen, Melissa Dickey, Tom R. DeMeester

Published in: Surgical Endoscopy | Issue 3/2010

Abstract

Background

Laparoscopic repair of an intrathoracic stomach has been associated with a high recurrence rate. The use of biologic or synthetic mesh to reinforce the crural repair has been shown to reduce recurrence. This study aimed to assess a simplified technique for reinforcing the crural repair using absorbable Vicryl mesh secured with BioGlue during laparoscopic repair of an intrathoracic stomach.

Methods

The charts of all patients who underwent laparoscopic repair of an intrathoracic stomach from June 2006 to March 2009 using the described technique were retrospectively reviewed. Intrathoracic stomach was defined as more than 50% of the stomach herniated into the chest. Follow-up assessment was routinely performed 1 year or more after surgery and included endoscopy, video esophagram, Bravo 48-h pH monitoring, and a gastroesophageal reflux disease (GERD)–health-related quality-of-life (HRQL) questionnaire.

Results

A total of 35 patients (male:female = 10:25) with a mean age of 70 years (48–89 years) and a mean body mass index (BMI) of 30.4 kg/m² (20.4–44.8 kg/m²) underwent repair using this technique. The median operating time was 144 min (101–311 min), and the median hospital stay was 2 days (1–21 days). There were three conversions (8.6%) and one intraoperative complication (2.9%). Three patients (8.6%) experienced postoperative complications. No mesh-related complications occurred. Follow-up assessment 1 year or more after surgery was available for 21 of the 25 eligible patients [median follow-up period, 14 months (11–34 months)]. There were two recurrences (9.5%), one of them asymptomatic. The median GERD-HRQL score was 5 (2–28). Nearly all the patients (91.3%) were satisfied with the operation, and 96% would have it again.

Conclusion

Vicryl mesh secured with BioGlue is a simple and easy method for reinforcing the crural closure during laparoscopic repair of an intrathoracic stomach. The recurrence rate at 1 year is low and comparable with that of other series using biologic mesh secured with sutures or tacks.

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Title: A simplified technique for intrathoracic stomach repair: laparoscopic fundoplication with Vicryl mesh and BioGlue crural reinforcement
Authors: Jörg Zehetner
John C. Lipham
Shahin Ayazi
Arzu Oezcelik
Emmanuele Abate
Weisheng Chen
Steven R. DeMeester
Helen J. Sohn
Farzaneh Banki
Jeffrey A. Hagen
Melissa Dickey
Tom R. DeMeester
Publication date: 01-03-2010
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 3/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-009-0662-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A simplified technique for intrathoracic stomach repair: laparoscopic fundoplication with Vicryl mesh and BioGlue crural reinforcement

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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