%0 Journal Article
%T Management of complications after laparoscopic Nissen's fundoplication: a surgeon's perspective
%A Tarun Singhal
%A Santosh Balakrishnan
%A Abdulzahra Hussain
%A Starlene Grandy-Smith
%A Andrew Paix
%A Shamsi El-Hasani
%J Annals of Surgical Innovation and Research
%D 2009
%I BioMed Central
%R 10.1186/1750-1164-3-1
%X 301 patients underwent laparoscopic treatment for GORD by a single consultant surgeon in our NHS Trust from September 1999. The data was prospectively collected and entered into a database. The data was retrospectively analysed for presentations for complications and their management.Surgery was completed laparoscopically in all patients, except in five, where the operation was technically difficult due to pre-existing conditions. The complications we encountered during surgery and follow-up period were major intra-operative bleeding (n = 1, 0.33%), severe post-operative nausea and vomiting (n = 1, 0.33%), wound infection (n = 3, 1%), port-site herniation (n = 1, 0.33%), wrap-migration (n = 2, 0.66%), wrap-ischaemia (n = 1, 0.33%), recurrent regurgitation (n = 4, 1.32%), recurrent heartburn (n = 29, 9.63%), tension pneumothorax (n = 2, 0.66%), surgical emphysema (n = 8, 2.66%), and port-site pain (n = 4, 1.33%).Minimal access approach to treat GORD has presented with some specific and unique complications. It is important to recognise these complications at the earliest possible stage as some of these patients may present in an acute setting requiring emergency surgery. All members of the department, and not just the members of the specialised team, should be aware about these complications to minimise the morbidity and mortality.Gastro-oesophageal reflux disease (GORD) is a common problem in the western world with an incidence of 5 per 1000 population per year [1]. The majority of patients have mild symptoms requiring only occasional treatment. However, a minority have persistent symptoms refractory to medical management and may go on to develop significant complications. This latter group initiated the interest in minimal access surgical approaches to treatment pioneered in the early 1990s.Studies have confirmed the strong association between GORD and the risk of oesophageal adenocarcinoma [2]. GORD is also implicated in the aetiology of a number of related disord
%U http://www.asir-journal.com/content/3/1/1