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Fundoplication Complications
Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Diagnostic Checklist

        TERMINOLOGY

        • Abbreviations

          • Fundoplication (FDP)
        • Definitions

          • Complications of antireflux surgery for management of gastroesophageal reflux disease (GERD)
          • Nissen FDP: Complete (360°) FDP
            • Approach: Laparoscopic or open FDP
            • Gastric fundus wrapped 360° around intraabdominal esophagus to create antireflux valve
            • Concomitant hiatial hernia is reduced; diaphragmatic esophageal hiatus sutured
          • Toupet FDP: Partial (270°) FDP
            • Posterior hemivalve created
          • Belsey Mark IV repair: Open surgical; 240° FDP wrap around left lateral aspect of distal esophagus
            • Fundus sutured to intraabdominal esophagus; acute esophagogastric junction angle (angle of His)
            • Can also be performed via minimally invasive techniques

        IMAGING

        • General Features

          • Radiographic Findings

            • CT Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              Selected References

                              1. Schijven MP et al: Laparoscopic surgery for gastro-esophageal acid reflux disease. Best Pract Res Clin Gastroenterol. 28(1):97-109, 2014
                              2. Jobe BA et al: Preoperative diagnostic workup before antireflux surgery: an evidence and experience-based consensus of the Esophageal Diagnostic Advisory Panel. J Am Coll Surg. 217(4):586-97, 2013
                              3. LeBedis CA et al: The diagnostic and therapeutic role of imaging in postoperative complications of esophageal surgery. Semin Ultrasound CT MR. 34(4):288-98, 2013
                              4. Epstein D et al: Laparoscopic fundoplication compared with medical management for gastro-oesophageal reflux disease: cost effectiveness study. BMJ. 339:b2576, 2009
                              5. Furga P et al: [The outcomes of treatment of gastroesophageal reflux disease with laparoscopic "floppy" fundoplication.] Pol Merkur Lekarski. 26(155):395-8, 2009
                              6. Hamdy E et al: Response of atypical symptoms of GERD to antireflux surgery. Hepatogastroenterology. 56(90):403-6, 2009
                              7. Baker ME et al: Gastroesophageal reflux disease: integrating the barium esophagram before and after antireflux surgery. Radiology. 243(2):329-39, 2007
                              8. Graziano K et al: Recurrence after laparoscopic and open Nissen fundoplication: a comparison of the mechanisms of failure. Surg Endosc. 17(5):704-7, 2003
                              9. Fernando HC et al: Outcomes of laparoscopic Toupet compared to laparoscopic Nissen fundoplication. Surg Endosc. 16(6):905-8, 2002
                              10. Hainaux B et al: Intrathoracic migration of the wrap after laparoscopic Nissen fundoplication: radiologic evaluation. AJR Am J Roentgenol. 178(4):859-62, 2002
                              11. Pavlidis TE: Laparoscopic Nissen fundoplication. Minerva Chir. 56(4):421-6, 2001
                              12. Waring JP: Postfundoplication complications. Prevention and management. Gastroenterol Clin North Am. 28(4):1007-19, viii-ix, 1999
                              Related Anatomy
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                              Related Differential Diagnoses
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                              References
                              Tables

                              Tables

                              KEY FACTS

                              • Terminology

                                • Imaging

                                  • Diagnostic Checklist

                                    TERMINOLOGY

                                    • Abbreviations

                                      • Fundoplication (FDP)
                                    • Definitions

                                      • Complications of antireflux surgery for management of gastroesophageal reflux disease (GERD)
                                      • Nissen FDP: Complete (360°) FDP
                                        • Approach: Laparoscopic or open FDP
                                        • Gastric fundus wrapped 360° around intraabdominal esophagus to create antireflux valve
                                        • Concomitant hiatial hernia is reduced; diaphragmatic esophageal hiatus sutured
                                      • Toupet FDP: Partial (270°) FDP
                                        • Posterior hemivalve created
                                      • Belsey Mark IV repair: Open surgical; 240° FDP wrap around left lateral aspect of distal esophagus
                                        • Fundus sutured to intraabdominal esophagus; acute esophagogastric junction angle (angle of His)
                                        • Can also be performed via minimally invasive techniques

                                    IMAGING

                                    • General Features

                                      • Radiographic Findings

                                        • CT Findings

                                          • Imaging Recommendations

                                            DIFFERENTIAL DIAGNOSIS

                                              PATHOLOGY

                                              • General Features

                                                CLINICAL ISSUES

                                                • Presentation

                                                  • Demographics

                                                    • Natural History & Prognosis

                                                      • Treatment

                                                        DIAGNOSTIC CHECKLIST

                                                        • Consider

                                                          Selected References

                                                          1. Schijven MP et al: Laparoscopic surgery for gastro-esophageal acid reflux disease. Best Pract Res Clin Gastroenterol. 28(1):97-109, 2014
                                                          2. Jobe BA et al: Preoperative diagnostic workup before antireflux surgery: an evidence and experience-based consensus of the Esophageal Diagnostic Advisory Panel. J Am Coll Surg. 217(4):586-97, 2013
                                                          3. LeBedis CA et al: The diagnostic and therapeutic role of imaging in postoperative complications of esophageal surgery. Semin Ultrasound CT MR. 34(4):288-98, 2013
                                                          4. Epstein D et al: Laparoscopic fundoplication compared with medical management for gastro-oesophageal reflux disease: cost effectiveness study. BMJ. 339:b2576, 2009
                                                          5. Furga P et al: [The outcomes of treatment of gastroesophageal reflux disease with laparoscopic "floppy" fundoplication.] Pol Merkur Lekarski. 26(155):395-8, 2009
                                                          6. Hamdy E et al: Response of atypical symptoms of GERD to antireflux surgery. Hepatogastroenterology. 56(90):403-6, 2009
                                                          7. Baker ME et al: Gastroesophageal reflux disease: integrating the barium esophagram before and after antireflux surgery. Radiology. 243(2):329-39, 2007
                                                          8. Graziano K et al: Recurrence after laparoscopic and open Nissen fundoplication: a comparison of the mechanisms of failure. Surg Endosc. 17(5):704-7, 2003
                                                          9. Fernando HC et al: Outcomes of laparoscopic Toupet compared to laparoscopic Nissen fundoplication. Surg Endosc. 16(6):905-8, 2002
                                                          10. Hainaux B et al: Intrathoracic migration of the wrap after laparoscopic Nissen fundoplication: radiologic evaluation. AJR Am J Roentgenol. 178(4):859-62, 2002
                                                          11. Pavlidis TE: Laparoscopic Nissen fundoplication. Minerva Chir. 56(4):421-6, 2001
                                                          12. Waring JP: Postfundoplication complications. Prevention and management. Gastroenterol Clin North Am. 28(4):1007-19, viii-ix, 1999