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Robotic Laparoscopic Belsey Fundoplasty For Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is one of the most common diseases in humans, affecting approximately 20 percent of Americans. Normal individuals experience some GERD on a regular basis. Ongoing GERD can result in injury to the esophagus and the upper aero-digestive tract and in some cases it has been shown to be a strong risk factor for esophageal cancer (carcinoma). Curiously, esophageal adenocarcinoma has nearly quadrupled in frequency in the United States since the 1980s, when oral and acid medications have had their greatest use.

GERD classically presents as heartburn and regurgitation. In addition to the classic presentation, GERD can present with a number of atypical symptoms which stem from exposure of the upper aerodigestive tract to gastric contents.

Robotic Surgical Treatment
A Belsey Mark IV Fundoplication can be performed laparoscopically using the daVinci Robot and is associated with good reflux control and less dysphagia as compared to the Nissen Fundoplication wrap.

Clinical outcomes:

  • During a 42-month period, 73 patients (39 men, 34 women, mean age 38+/-9 yrs.) with gastroesophageal reflux disease underwent a robot-assisted laparoscopic modified Belsey fundoplication.
  • 59% patients scored zero and were completely free of reflux symptoms.
  • 91% had a Visick score I or II (complaints resolved or improved)
  • Sixty nine patients (94%) had transient postoperative dysphagia which resolved by the third postoperative week.
  • There was no long term dysphagia.
  • Recurrent hiatal hernia was seen in 4 patients (5%).
  • Failure rate for the procedure was 8%.

Robotics in Thoracic Surgery

Overview

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Robotic Esophageal Myotomy for Achalasia

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Robotic Laparoscopic Belsey Fundoplasty for Gastroesophageal Reflux Disease

Thoracic Surgery Main Page

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