One hundred consecutive laparoscopic Nissen's without the use of a bougie

Victor Bochkarev, Atif Iqbal, Yong Kwon Lee, Michelle Vitamvas, Dmitry Oleynikov

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The creation of a floppy and symmetric fundoplication over a bougie has been the standard of care in laparoscopic surgery. The use of a bougie carries a risk of esophageal perforation but lowers the risk of postoperative dysphagia. Intraoperative esophagogastroduodenoscopy (IEGD) can be used to assess the orientation and position of a properly constructed Nissen. The aim of this study was to determine if IEGD can replace the routine use of a bougie in the creation of a fundoplication. Methods: One hundred consecutive patients undergoing laparoscopic Nissen fundoplication from 2003 to 2005 were entered into a prospective database. IEGD was used in all patients instead of a bougie. Preoperative and postoperative data, including symptom scores, pH studies, manometry, and upper gastrointestinal studies, were analyzed. Results: All 100 patients completed the study for a mean follow-up period of 18 months. The mean surgical time was 102 minutes. The mean intraoperative endoscopy time was 14 minutes. There were a total of 24 (24%) alterations of the fundoplication performed according to endoscopic wrap creation. The most common alteration was removal of a fundoplication stitch in 15 patients with a tight appearance of wrap. There were no major complications. Two patients required esophageal dilatation for mild to moderate dysphagia. Conclusions: IEGD is a valuable tool for laparoscopic Nissen fundoplication. IEGD helps to appreciate the true location of the gastroesophageal junction and allows for fundoplication adjustment based on additional visualization. The creation of a symmetric and floppy wrap during Nissen fundoplication can be facilitated greatly by intraoperative endoscopy and may lead to improved clinical outcomes without the risk of esophageal perforation.

Original languageEnglish (US)
Pages (from-to)866-871
Number of pages6
JournalAmerican journal of surgery
Volume194
Issue number6
DOIs
StatePublished - Dec 1 2007

Fingerprint

Fundoplication
Digestive System Endoscopy
Esophageal Perforation
Deglutition Disorders
Endoscopy
Esophagogastric Junction
Manometry
Standard of Care
Operative Time
Laparoscopy
Dilatation
Databases

Keywords

  • Intraoperative endoscopy
  • Laparoscopy
  • Nissen fundoplication

ASJC Scopus subject areas

  • Surgery

Cite this

Bochkarev, V., Iqbal, A., Lee, Y. K., Vitamvas, M., & Oleynikov, D. (2007). One hundred consecutive laparoscopic Nissen's without the use of a bougie. American journal of surgery, 194(6), 866-871. https://doi.org/10.1016/j.amjsurg.2007.08.042

One hundred consecutive laparoscopic Nissen's without the use of a bougie. / Bochkarev, Victor; Iqbal, Atif; Lee, Yong Kwon; Vitamvas, Michelle; Oleynikov, Dmitry.

In: American journal of surgery, Vol. 194, No. 6, 01.12.2007, p. 866-871.

Research output: Contribution to journalArticle

Bochkarev, V, Iqbal, A, Lee, YK, Vitamvas, M & Oleynikov, D 2007, 'One hundred consecutive laparoscopic Nissen's without the use of a bougie', American journal of surgery, vol. 194, no. 6, pp. 866-871. https://doi.org/10.1016/j.amjsurg.2007.08.042
Bochkarev, Victor ; Iqbal, Atif ; Lee, Yong Kwon ; Vitamvas, Michelle ; Oleynikov, Dmitry. / One hundred consecutive laparoscopic Nissen's without the use of a bougie. In: American journal of surgery. 2007 ; Vol. 194, No. 6. pp. 866-871.
@article{4060b28a5d4f48c2b0c1206123ddaa36,
title = "One hundred consecutive laparoscopic Nissen's without the use of a bougie",
abstract = "Background: The creation of a floppy and symmetric fundoplication over a bougie has been the standard of care in laparoscopic surgery. The use of a bougie carries a risk of esophageal perforation but lowers the risk of postoperative dysphagia. Intraoperative esophagogastroduodenoscopy (IEGD) can be used to assess the orientation and position of a properly constructed Nissen. The aim of this study was to determine if IEGD can replace the routine use of a bougie in the creation of a fundoplication. Methods: One hundred consecutive patients undergoing laparoscopic Nissen fundoplication from 2003 to 2005 were entered into a prospective database. IEGD was used in all patients instead of a bougie. Preoperative and postoperative data, including symptom scores, pH studies, manometry, and upper gastrointestinal studies, were analyzed. Results: All 100 patients completed the study for a mean follow-up period of 18 months. The mean surgical time was 102 minutes. The mean intraoperative endoscopy time was 14 minutes. There were a total of 24 (24{\%}) alterations of the fundoplication performed according to endoscopic wrap creation. The most common alteration was removal of a fundoplication stitch in 15 patients with a tight appearance of wrap. There were no major complications. Two patients required esophageal dilatation for mild to moderate dysphagia. Conclusions: IEGD is a valuable tool for laparoscopic Nissen fundoplication. IEGD helps to appreciate the true location of the gastroesophageal junction and allows for fundoplication adjustment based on additional visualization. The creation of a symmetric and floppy wrap during Nissen fundoplication can be facilitated greatly by intraoperative endoscopy and may lead to improved clinical outcomes without the risk of esophageal perforation.",
keywords = "Intraoperative endoscopy, Laparoscopy, Nissen fundoplication",
author = "Victor Bochkarev and Atif Iqbal and Lee, {Yong Kwon} and Michelle Vitamvas and Dmitry Oleynikov",
year = "2007",
month = "12",
day = "1",
doi = "10.1016/j.amjsurg.2007.08.042",
language = "English (US)",
volume = "194",
pages = "866--871",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - One hundred consecutive laparoscopic Nissen's without the use of a bougie

AU - Bochkarev, Victor

AU - Iqbal, Atif

AU - Lee, Yong Kwon

AU - Vitamvas, Michelle

AU - Oleynikov, Dmitry

PY - 2007/12/1

Y1 - 2007/12/1

N2 - Background: The creation of a floppy and symmetric fundoplication over a bougie has been the standard of care in laparoscopic surgery. The use of a bougie carries a risk of esophageal perforation but lowers the risk of postoperative dysphagia. Intraoperative esophagogastroduodenoscopy (IEGD) can be used to assess the orientation and position of a properly constructed Nissen. The aim of this study was to determine if IEGD can replace the routine use of a bougie in the creation of a fundoplication. Methods: One hundred consecutive patients undergoing laparoscopic Nissen fundoplication from 2003 to 2005 were entered into a prospective database. IEGD was used in all patients instead of a bougie. Preoperative and postoperative data, including symptom scores, pH studies, manometry, and upper gastrointestinal studies, were analyzed. Results: All 100 patients completed the study for a mean follow-up period of 18 months. The mean surgical time was 102 minutes. The mean intraoperative endoscopy time was 14 minutes. There were a total of 24 (24%) alterations of the fundoplication performed according to endoscopic wrap creation. The most common alteration was removal of a fundoplication stitch in 15 patients with a tight appearance of wrap. There were no major complications. Two patients required esophageal dilatation for mild to moderate dysphagia. Conclusions: IEGD is a valuable tool for laparoscopic Nissen fundoplication. IEGD helps to appreciate the true location of the gastroesophageal junction and allows for fundoplication adjustment based on additional visualization. The creation of a symmetric and floppy wrap during Nissen fundoplication can be facilitated greatly by intraoperative endoscopy and may lead to improved clinical outcomes without the risk of esophageal perforation.

AB - Background: The creation of a floppy and symmetric fundoplication over a bougie has been the standard of care in laparoscopic surgery. The use of a bougie carries a risk of esophageal perforation but lowers the risk of postoperative dysphagia. Intraoperative esophagogastroduodenoscopy (IEGD) can be used to assess the orientation and position of a properly constructed Nissen. The aim of this study was to determine if IEGD can replace the routine use of a bougie in the creation of a fundoplication. Methods: One hundred consecutive patients undergoing laparoscopic Nissen fundoplication from 2003 to 2005 were entered into a prospective database. IEGD was used in all patients instead of a bougie. Preoperative and postoperative data, including symptom scores, pH studies, manometry, and upper gastrointestinal studies, were analyzed. Results: All 100 patients completed the study for a mean follow-up period of 18 months. The mean surgical time was 102 minutes. The mean intraoperative endoscopy time was 14 minutes. There were a total of 24 (24%) alterations of the fundoplication performed according to endoscopic wrap creation. The most common alteration was removal of a fundoplication stitch in 15 patients with a tight appearance of wrap. There were no major complications. Two patients required esophageal dilatation for mild to moderate dysphagia. Conclusions: IEGD is a valuable tool for laparoscopic Nissen fundoplication. IEGD helps to appreciate the true location of the gastroesophageal junction and allows for fundoplication adjustment based on additional visualization. The creation of a symmetric and floppy wrap during Nissen fundoplication can be facilitated greatly by intraoperative endoscopy and may lead to improved clinical outcomes without the risk of esophageal perforation.

KW - Intraoperative endoscopy

KW - Laparoscopy

KW - Nissen fundoplication

UR - http://www.scopus.com/inward/record.url?scp=36048994598&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=36048994598&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2007.08.042

DO - 10.1016/j.amjsurg.2007.08.042

M3 - Article

C2 - 18005786

AN - SCOPUS:36048994598

VL - 194

SP - 866

EP - 871

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

IS - 6

ER -