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By George Y. Wu

Textual content describes all the surgical and laparoscopic tactics now used for the gastrointestinal tract. contains transparent, halftone illustrations and discussions of anatomical and physiological adjustments. additionally deals suggestion at the scientific administration of the postsurgical sufferer. For physicians. DNLM: Digestive method Surgical Procedures--methods.

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Extra resources for An Internist's Illustrated Guide to Gastrointestinal Surgery (Clinical Gastroenterology)

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Ann Otol Rhino Laryng 1994;103:31–35. 5. Aggerholm K, Illum P. Surgical treatment of Zenkers diverticulum. J Laryngol Otol 1990;104:312–314. 6. Dohlman G, Mattsson O. The endoscopic operation for hypopharyngeal diverticula. Arch Otolaryngol 1960;71:744–752. 7. Cook C, Huang P, Richstmeier W, et al. Endoscopic staple assisted esophagodiverticulostomy for Zenker’s diverticulum. Laryngoscope 2000;110:2020–2025. 8. Scher R, Richtsmeier W. Long-term experience with endoscopic staple assisted esophagodiverticulostomy for Zenkers diverticulum.

In the Dor fundoplication, the proximal fundus is sutured to the hiatus and the divided esophageal musculature (Fig. 4). The instruments and trocars are removed. 5-cm to 1-cm incisions are closed with absorbable sutures and Band-Aids®. Nasogastric tubes are not necessary. The patient begins a liquid diet that evening and is discharged the following day. Dysphagia is immediately improved. The postoperative pain, recovery, and return to work are similar to that seen in elective laparoscopic cholecystectomy.

SUMMARY 1. GERD is a common condition and majority of patients are managed effectively by medical therapy. 2. Antireflux surgery restores the mechanically defective esophageal sphincter and is an effective treatment in patients suffering from severe GERD, which is unresponsive to medical therapy. 3. Laparoscopic Nissen fundoplication is the superior antireflux procedure for the majority of patients requiring surgery for GERD, but it is technically demanding and should be performed by properly trained and experienced surgeons.

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