Skip to main content
SpringerLink
Log in

Minimally invasive surgery for benign esophageal disorders: first 200 cases

  • Original Article
  • Published:
European Surgery Aims and scope Submit manuscript

Summary

Background

To evaluate the method of introduction, feasibility, and early results of a laparoscopic surgery for benign foregut disorders in a single high volume center.

Methods

A retrospective clinical study included consecutively laparoscopically operated patients due to benign foregut disorders. The study was conducted at the Department of Esophagogastric Surgery, First Surgical University Hospital, School of Medicine, University of Belgrade from March 2010 until July 2014. Complete preoperative diagnostics data, details of surgical procedures, and follow-up results are included.

Results

Overall, 200 consecutive patients were enrolled in the study. GERD and achalasia were the most common indications for laparoscopic surgery, with 81 and 72 patients respectively. Due to giant hiatal hernia, 37 patients were operated on, while the rest were less common indications. There were no conversions to open procedures. In three patients, pneumothorax resulted from intraoperative pleural lesion. One mucosal perforation occurred in an achalasia patient. One reoperation was conducted due to excessive port site bleeding. Short term follow-up results are highly satisfactory, and are presented in detail for every patient group.

Conclusion

Introduction of laparoscopy in a foregut surgery high volume center for the treatment of benign foregut disorders can be obtained with low incidence of complications, and satisfactory short term functional results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Bello B, Herbella FA, Allaix ME, Patti MG. Impact of minimally invasive surgery on the treatment of benign esophageal disorders. World J Gastroenterol. 2012;18:6764–70.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Pellegrini C, Wetter LA, Patti M, Leichter R, Mussan G, Mori T, Bernstein G, Way L. Thoracoscopic esophagomyotomy. Initial experience with a new approach for the treatment of achalasia. Ann Surg. 1992;216:291–6; discussion 296–9.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Hinder RA, Filipi CJ, Wetscher G, Neary P, DeMeester TR, Perdikis G. Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Ann Surg. 1994;220:472–81.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Zaninotto G, Costantini M, Rizzetto C, Zanatta L, Guirroli E, Portale G, Nicoletti L, Cavallin F, Battaglia G, Ruol A, Ancona E. Four hundred laparoscopic myotomies for esophageal achalasia: a single centre experience. Ann Surg. 2008;248:986–93.

    Article  PubMed  Google Scholar 

  5. Patti MG, Molena D, Fisichella PM, Whang K, Yamada H, Perretta S, Way LW. Laparoscopic Heller myotomy and Dor fundoplication for achalasia: analysis of successes and failures. Arch Surg. 2001;136:870–7.

    Article  CAS  PubMed  Google Scholar 

  6. Salvador R, Costantini M, Zaninotto G, Morbin T, Rizzetto C, Zanatta L, Ceolin M, Finotti E, Nicoletti L, Da Dalt G, Cavallin F, Ancona E. The preoperative manometric pattern predicts the outcome of surgical treatment for esophageal achalasia. J Gastrointest Surg. 2010;14:1635–45.

    Article  PubMed  Google Scholar 

  7. Rice T, Blackstone E. Surgical management of gastroesophageal reflux disease. Gastroenterol Clin N Am. 2008;37:901–19.

    Article  Google Scholar 

  8. Salminen P, Hurme S, Ovaska J. Fifteen-year outcome of laparoscopic and open Nissen fundoplication: a randomized clinical trial. Ann Thorac Surg. 2012;93:228–33.

    Article  PubMed  Google Scholar 

  9. Davis CS, Baldea A, Johns JR, Joehl RJ, Fisichella PM. The evolution and long-term results of laparoscopic antireflux surgery for the treatment of gastroesophageal reflux disease. JSLS. 2010;14:332–41.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Schauer PR, Ikramuddin S, McLaughlin RH, Graham TO, Slivka A, Lee KK, Schraut WH, Luketich JD. Comparison of laparoscopic versus open repair of paraesophageal hernia. Am J Surg. 1998;176:659–65.

    Article  CAS  PubMed  Google Scholar 

  11. Simic´ AP, Skrobic´  OM, Radovanovic´ N, Velicˇkovic´ D, Ivanovic´ N, Peško PM. Importance of ineffective esophageal motility in patients with erosive reflux disease on the long-term outcome of Nissen fundoplication. Eur Surg. 2013;45:15–20.

    Article  Google Scholar 

  12. Broeders JA, Sportel IG, Jamieson GG, Nijjar RS, Granchi N, Myers JC, Thompson SK. Impact of ineffective oesophageal motility and wrap type on dysphagia after laparoscopic fundoplication. Br J Surg. 2011;98:1414–21.

    Article  CAS  PubMed  Google Scholar 

  13. Horstmann R, Classen C, Röttgermann S, Langer M, Palmes D. Long-term experience of treating 185 patients with gastroesophageal reflux disease (GERD) by anti-reflux surgery respecting the functional–morphological restoration of the esophagus. Langenbecks Arch Surg. 2006;391:24–31.

    Article  CAS  PubMed  Google Scholar 

  14. Zehetner J, Demeester SR, Ayazi S, Kilday P, Augustin F, Hagen JA, Lipham JC, Sohn HJ, DeMeester TR. Laparoscopic versus open repair of paraesophageal hernia: the second decade. J Am Coll Surg. 2011;212:813–20.

    Article  PubMed  Google Scholar 

  15. Nason KS, Luketich JD, Qureshi I, Keeley S, Trainor S, Awais O, Shende M, Landreneau RJ, Jobe BA, Pennathur A. Laparoscopic repair of giant paraesophageal hernia results in longterm patient satisfaction and a durable repair. J Gastrointest Surg. 2008;12:2066–75.

    Article  PubMed  Google Scholar 

  16. Davis SS Jr. Current controversies in paraesophageal hernia repair. Surg Clin North Am. 2008;88:959–78.

    Article  PubMed  Google Scholar 

  17. Salminen PT, Hiekkanen HI, Rantala AP, Ovaska JT. Comparison of long-term outcome of laparoscopic and conventional Nissen fundoplication: a prospective randomized study with an 11-year follow-up. Ann Surg. 2007;246:201–6.

  18. Rice TW, Blackstone EH. Surgical management of gastroesophageal reflux disease. Gastroenterol Clin N Am. 2008;37:901–19.

    Article  Google Scholar 

  19. Simic´ AP, Radovanovic´ NS, Skrobic´ OM, Ražnatovic´ ZJ, Peško PM. Significance of limited hiatal dissection in surgery for achalasia. J Gastrointest Surg. 2010;14:587–93.

    Article  PubMed  Google Scholar 

  20. Campos G M, Vittinghoff E, Rabl C, Takata M, Gadenstatter M, Lin F, Ciovica R. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg. 2009;249:45–57.

    Article  PubMed  Google Scholar 

  21. Rakita S, Bloomston M, Villadolid D, Thometz D, Boe B, Rosemurgy A. Age affects presenting symptoms of achalasia and outcomes after myotomy. Am Surg. 2005:71:424–9.

    PubMed  Google Scholar 

  22. Ancona E, Anselmino M, Zaninotto G, Costantini M, Rossi M, Bonavina L, Boccu C, Buin F, Peracchia A. Esophageal achalasia: laparoscopic versus conventional open Heller-Dor operation. Am J Surg. 1995;170:265–70.

    Article  CAS  PubMed  Google Scholar 

  23. Douard R, Gaudric M, Chaussade S, Couturier D, Houssin D, Dousset B. Functional results after laparoscopic Heller myotomy for achalasia: a comparative study to open surgery. Surgery. 2004;136:16–24.

    Article  PubMed  Google Scholar 

  24. Stefanidis D, Richardson W, Farrell TM, Kohn GP, Augenstein V, Fanelli RD. SAGES guidelines for the surgical treatment of esophageal achalasia. Surg Endosc. 2012;26:296–311.

    Article  PubMed  Google Scholar 

  25. Fumagalli Romario U Ceolin M Porta M Rosati R. Laparoscopic repair of epiphrenic diverticulum. Semin Thorac Cardiovasc Surg. 2012;24:213–7.

    Article  PubMed  Google Scholar 

  26. Zaninotto G, Portale G, Costantini M, Zanatta L, Salvador R, Ruol A. Therapeutic strategies for epiphrenic diverticula: systematic review. World J Surg. 2011;35:1447–53.

    Article  PubMed  Google Scholar 

  27. Bathia L, Legner A, Tsuboi K, Mittal S. Efficasy and feasibility of laparoscopic redo fundoplication. World J Surg. 2011;35(11):2445–53.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Esophagogastric Surgery, University Hospital for Digestive Surgery—First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica St 6, 11.000, Belgrade, Serbia

    A.P. Simic´ MD, PhD,  O.M. Skrobić,  D. Veličković, Z. Ražnatović, V. Šljukić, N. Ivanović &  P.M. Peško

  2. Department of Radiology, University Hospital for Digestive Surgery—First Surgical University Hospital,Clinical Center of Serbia, Belgrade, Serbia

    Đ. Šaranović & S. Jovanović

  3. School of Medicine, University of Belgrade, Belgrade, Serbia

    A.P. Simic´ MD, PhD,  O.M. Skrobić,  D. Veličković,  Đ. Šaranović &  P.M. Peško

Authors
  1. A.P. Simic´ MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O.M. Skrobić
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D. Veličković
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Z. Ražnatović
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Đ. Šaranović
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. V. Šljukić
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Jovanović
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. N. Ivanović
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P.M. Peško
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A.P. Simic´ MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Simic´, A., Skrobić, O., Veličković, D. et al. Minimally invasive surgery for benign esophageal disorders: first 200 cases. Eur Surg 47, 25–34 (2015). https://doi.org/10.1007/s10353-015-0296-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10353-015-0296-x

Keywords

Search

Navigation