Redo Nissen fundoplication with stapled-wedge Collis gastroplasty
Epublication WebSurg.com, Nov 2006;06(11). URL: http://websurg.com/doi/vd01en2029
This video demonstrates a redo laparoscopic Collis-Nissen gastroplasty in a patient with recurrent gastroesophageal reflux symptoms and short esophagus. The first step of this redo procedure consists in taking down the previous fundoplication in order to identify the mechanism underlying the failure of the initial repair. The surgeon demonstrates an extensive mobilization of the esophagus through the hiatus to achieve an adequate length of intra-abdominal esophagus. Despite this, the esophagus was too short and the surgeon performs a Collis gastroplasty using the wedge gastrectomy technique over a 50 French bougie. A 2.5cm of tension-free intra-abdominal esophagus is achieved. The hiatus is repaired with interrupted non-absorbable sutures. A standard Nissen fundoplication is performed.