Skip to main content
SpringerLink
Log in

Endoscopic Evaluation of Post-Fundoplication Anatomy

  • Esophagus (J Clarke and N Ahuja, Section Editors)
  • Published:
Current Gastroenterology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

We aim to review the endoscopic evaluation of post-fundoplication anatomy and its role in assessment of fundoplication outcomes and in pre-operative planning for reoperation in failed procedures.

Recent Findings

There is no universally accepted system for evaluating post-fundoplication anatomy endoscopically. However, multiple reports described the usefulness of post-operative endoscopy as a quality control measure and in the evaluation of complex cases such as repeat procedures and paraesophageal hernias (PEH).

Summary

Endoscopic evaluation of post-fundoplication anatomy has an important role in assessing the outcomes of operative repair and pre-operative planning for failed fundoplications. Attempts have been made to characterize the appearance of the newly formed gastroesophageal valve after successful repairs and to standardize endoscopic reporting and classification of anatomic descriptions of failed fundoplications. However, there is no consensus. More studies are needed to evaluate the applicability and reproducibility of proposed endoscopic evaluation systems in order for such tools to become widely accepted.

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

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. •• Jobe BA, Kahrilas PJ, Vernon AH, Sandone C, Gopal DV, Swanstrom LL, et al. Endoscopic appraisal of the gastroesophageal valve after antireflux surgery. Am J Gastroenterol. 2004;99(2):233–43. This study is considered the first attempt to characterize the endoscopic findings of normal successful fundoplications and proposed an endoscopic lexicon to report these criteria.

    Article  PubMed  Google Scholar 

  2. Liebermann-Meffert D, Allgower M, Schmid P, et al. Muscular equivalent of the lower esophageal sphincter. Gastroenterology. 1979;76:31–8.

    CAS  PubMed  Google Scholar 

  3. Adler RH, Firme NC, Lanigan JM. A valve mechanism to prevent gastroesophageal reflux and esophagitis. Surgery. 1958;44:63–75.

    CAS  PubMed  Google Scholar 

  4. Hill LD, Kozarek RA. The gastroesophageal flap valve. J Clin Gastroenterol. 1999;28:1947.

    Article  Google Scholar 

  5. Hill LD, Kozarek RA, Kraemer SJ, et al. The gastroesophageal flap valve: in vitro and in vivo observations. Gastrointest Endosc. 1996;44:541–7.

    Article  CAS  PubMed  Google Scholar 

  6. Contractor QQ, Akhtar SS, Contractor TQ. Endoscopic esophagitis and gastroesophageal flap valve. J Clin Gastroenterol. 1999;28:233–7.

    Article  CAS  PubMed  Google Scholar 

  7. Oberg S, Peters JH, DeMeester TR, et al. Endoscopic grading of the gastroesophageal valve in patients with symptoms of gastroesophageal reflux disease (GERD). Surg Endosc. 1999;13:1184–8.

    Article  CAS  PubMed  Google Scholar 

  8. Korn O, Csendes A, Burdiles P, et al. Anatomic dilation of the cardia and competence of the lower esophageal sphincter: a clinical and experimental study. J Gastrointest Surg. 2000;4:398–406.

    Article  CAS  PubMed  Google Scholar 

  9. Klein WA, Parkman HP, Dempsey DT, et al. Sphincterlike thoracoabdominal high pressure zone after esophagogastrectomy. Gastroenterology. 1993;105:1362–9.

    Article  CAS  PubMed  Google Scholar 

  10. Fein M, Ritter MP, DeMeester TR, et al. Role of lower esophageal sphincter and hhiatal hernia in the pathogenesis of gastroesophageal reflux disease. J Gastrointest Surg. 1999;3:405–10.

    Article  CAS  PubMed  Google Scholar 

  11. Kahrilas PJ, Shi G, Manka M, et al. Increased frequency of transient lower esophageal sphincter relaxation induced by gastric distention in reflux patients with hiatal hernia. Gastroenterology. 2000;118:688–95.

    Article  CAS  PubMed  Google Scholar 

  12. Farrell TM, Smith CD, Metreveli RE, et al. Fundoplications resist reflux independent of in vivo anatomic relationships. Am J Surg. 1999;177:107–10.

    Article  CAS  PubMed  Google Scholar 

  13. Bammer T, Hinder RA, Klaus A, et al. Five- to eight-year outcome of the first laparascopic Nissen fundoplications. J Gastrointest Surg. 2001;5:42–8.

    Article  CAS  PubMed  Google Scholar 

  14. Anvari M, Allen C. Five-year comprehensive outcomes evaluation in 181 patients after laparascopic Nissen fundoplication. J Am Coll Surg. 2003;196:51–9.

    Article  PubMed  Google Scholar 

  15. Catarci M, Gentileschi P, Papi C, et al. Evidence-based appraisal of antireflux fundoplication. Ann Surg. 2004;239:325–37.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Dassinger MS, Torquati A, Houston HL, et al. Laparoscopic fundoplication: 5-year follow-up. Am Surg. 2004;70:691–4.

    CAS  PubMed  Google Scholar 

  17. Lafullarde T, Watson DI, Jamieson GG, et al. Laparoscopic Nissen fundoplication: five year results and beyond. Arch Surg. 2001;136:180–4.

    Article  CAS  PubMed  Google Scholar 

  18. Peters JH, DeMeester TR, Crookes P, et al. The treatment of gastroesophageal reflux disease with laparoscopic Nissen fundoplication: prospective evaluation of 100 patients with “typical” symptoms. Ann Surg. 1998;228:40–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Finks JF, Wei Y, Birkmeyer JD. The rise and fall of antireflux surgery in the United States. Surg Endosc. 2006;20:1698–701.

    Article  PubMed  Google Scholar 

  20. Jay AP, Watson ID. Changing work patterns for benign upper gastrointestinal and biliary disease: 1994-2007. ANZ J Surg. 2010;80:519–25.

    Article  PubMed  Google Scholar 

  21. • Juhasz A, Sundaram A, Hoshino M, Lee TH, Mittal SK. Endoscopic assessment of failed fundoplication: a case for standardization. Surg Endosc. 2011;25(12):3761–6. This study defined the problems and lack of uniformity in the description of endoscopic post-fundoplication findings.

    Article  PubMed  Google Scholar 

  22. •• Mittal SK, Juhasz A, Ramanan B, Hoshino M, Lee TH, Filipi CJ. A proposed classification for uniform endoscopic description of surgical fundoplication. Surg Endosc. 2014;28:1103–9. This study proposed the first classification system in an attempt to standardize the reporting system for endoscopic post-fundoplication findings.

    Article  PubMed  Google Scholar 

  23. Stark ME, Devault KR. Complications following fundoplication. Tech Gastrointest Endosc. 2006;8:40–53.

    Article  Google Scholar 

  24. Jailwala J, Massey B, Staff D, Shaker R, Hogan W. Post-fundoplication symptoms: the role for endoscopic assessment of fundoplication integrity. Gastrointest Endosc. 2001;54(3):351–6.

    Article  CAS  PubMed  Google Scholar 

  25. Stefanidis D, Hope WW, Kohn GP, Reardon PR, Richardson WS, Fanelli RD, et al. Guidelines for surgical treatment of gastroesophageal reflux disease. Surg Endosc. 2010;24:2647–69.

    Article  PubMed  Google Scholar 

  26. Broeders JA, Rijnhart-de Jong HG, Draaisma WA, Bredenoord AJ, Smout AJ, Gooszen HG. Ten-year outcome of laparoscopic and conventional nissen fundoplication: randomized clinical trial. Ann Surg. 2009;250:698–706.

    Article  PubMed  Google Scholar 

  27. Ross SB, Gal S, Teta AF, Luberice K, Rosemurgy AS. Late results after laparoscopic fundoplication denote durable symptomatic relief of gastroesophageal reflux disease. Am J Surg. 2013;206:47–51.

    Article  PubMed  Google Scholar 

  28. Dallemagne B, Weerts J, Markiewicz S, Dewandre JM, Wahlen C, Monami B, et al. Clinical results of laparoscopic fundoplication at ten years after surgery. Surg Endosc. 2006;20:159–65.

    Article  CAS  PubMed  Google Scholar 

  29. Dallemagne B, Perretta S. Twenty years of laparoscopic fundoplication for GERD. World J Surg. 2011;35:1428–35.

    Article  PubMed  Google Scholar 

  30. Mardani J, Lundell L, Engström C. Total or posterior partial fundoplication in the treatment of GERD: results of a randomized trial after 2 decades of follow-up. Ann Surg. 2011;253:875–8.

    Article  PubMed  Google Scholar 

  31. Engström C, Cai W, Irvine T, Devitt PG, Thompson SK, Game PA, et al. Twenty years of experience with laparoscopic antireflux surgery. Br J Surg. 2012;99:1415–21.

    Article  PubMed  Google Scholar 

  32. Celasin H, Genc V, Celik SU, Turkcapar AG. Laparoscopic revision surgery for gastroesophageal reflux disease. Medicine. 2017;96:1–4.

    Article  Google Scholar 

  33. Hoshino M, Srinivasan A, Mittal SK. High-resolution manometry patterns of lower esophageal sphincter complex in symptomatic post-fundoplication patients. J Gastrointest Surg. 2012;16:705–14.

    Article  PubMed  Google Scholar 

  34. Yamamoto SR, Akimoto S, Hoshino M, Mittal SK. High-resolution manometry findings in symptomatic post-Nissen fundoplication patients with normal endoscopic configuration. Dis Esophagus. 2016;29:967–70.

    Article  CAS  PubMed  Google Scholar 

  35. Iqbal A, Awad Z, Simkins J, Shah R, Haider M, Salinas V, et al. Repair of 104 failed antireflux operations. Ann Surg. 2006;244:42–51.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Furnee EJ, Draaisma WA, Broeders IA, Gooszen HG. Surgical reintervention after failed antireflux surgery: a systematic review of the literature. J Gastrointest Surg. 2009;13:1539–49.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Khajanchee YS, O’Roukre R, Cassera MA, Gatta P, Hansen PD, Swanstrom LL. Laparoscopic reintervention for failed antireflux surgery. Arch Surg. 2007;142(8):785–92.

    Article  PubMed  Google Scholar 

  38. Hunter JG, Smith CD, Braunum GD, Waring JP, Trus TL, Cornwell M, et al. Laparoscopic fundoplication failures: patterns of failure and response to fundoplication revision. Ann Surg. 1999;230(4):595–606.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  39. Gopal DV, Chang EY, Kim CY, Sandone C, Pfau PR, Frick TJ, et al. EUS characteristics of Nissen fundoplication: normal appearance and mechanisms of failure. Gastrointest Endosc. 2006;63:35–44.

    Article  PubMed  Google Scholar 

  40. Chang EY, Minjarez RC, Kim CY, Seltman AK, Gopal DV, Diggs B, et al. Endoscopic ultrasound for the evaluation of Nissen fundoplication integrity: a blinded comparison with conventional testing. Surg Endosc. 2007;21:1719–25.

    Article  CAS  PubMed  Google Scholar 

  41. Skinner DB. Surgical management after failed antireflux operations. World J Surg. 1992;16:359–63.

    Article  CAS  PubMed  Google Scholar 

  42. Horgan S, Pohl D, Bogetti D, Eubanks T, Pellegrini C. Failed antireflux surgery: what have we learned from reoperations? Arch Surg. 1999;134:809–15.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Providence Portland Medical Center, Portland, OR, USA

    Walaa F. Abdelmoaty

  2. The Oregon Clinic, 4805 NE Glisan St, Suite 6N60, Portland, OR, 97213, USA

    Lee L. Swanstrom

  3. Institute for Image Guided Surgery, Strasbourg, France

    Lee L. Swanstrom

Authors
  1. Walaa F. Abdelmoaty
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lee L. Swanstrom
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lee L. Swanstrom.

Ethics declarations

Conflict of Interest

Walaa Abdelmoaty declares no conflict of interest.

Lee Swanstrom reports non-financial support from Apollo, Boston Scientific, and Olympus and grants from Olympus, outside the submitted work.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Esophagus

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Abdelmoaty, W.F., Swanstrom, L.L. Endoscopic Evaluation of Post-Fundoplication Anatomy. Curr Gastroenterol Rep 19, 51 (2017). https://doi.org/10.1007/s11894-017-0592-7

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11894-017-0592-7

Keywords

Search

Navigation