Southwestern Surgical CongressLaparoscopic reoperative antireflux surgery: A safe procedure with high patient satisfaction and low morbidity

- Safety and patient satisfaction in laparoscopic redo antireflux surgery.
- Achieving tension free esophageal length laparoscopically without Collis gastroplasty in redo antireflux surgery.
- Comparison of outcomes and patient satisfaction in laparoscopic and open redo antireflux surgery.

BackgroundLaparoscopic reoperative antireflux surgery remains challenging and the advantages compared to an open approach remain unclear.MethodsRetrospective chart review and follow-up questionnaire via phone.Results50 reoperative hiatal hernia repairs were performed in 47 patients. Values: median and interquartile range (IQR). There were 10 males, 37 females, 55 (49-66) years. Reoperative procedures: 38 laparoscopic vs. 12 open transabdominal. Length of operation: 185 (147-254) vs. 325 (276-394) minutes (p < 0.0008). Length of stay: 3 (2-4) vs.10 (8-13) days (p < 0.0001). None required Collis gastroplasty. There was no 30-day mortality. Follow-up questionnaire was obtained in 36/45 (80%) at 21 (11-40) months (2 cancer related deaths). In all, 24/36 (67%) were free of preoperative symptoms and 33/36 (92%) were satisfied with the operation. There was no difference between the laparoscopic and open group.ConclusionsLaparoscopic reoperative antireflux surgery is a safe approach with high patient satisfaction and low morbidity. Tension-free esophageal length can be achieved laparoscopically without Collis gastroplasty. The duration of the operation and length of stay are less in the laparoscopic vs. open group. Symptomatic relief and patient satisfaction are similar in both approaches.