Combined Laparoscopic and Robot-Assisted Gastroesophageal Dissociation for Recurrent Gastroesophageal Reflux Disease

Abstract

Abstract Introduction: Laparoscopic Nissen fundoplication has become a very important tool for controlling severe gastroesophageal reflux disease (GERD) in the pediatric population. However, some patients, especially those who are neurologically impaired, may develop recurrent GERD that is refractory to continued medical management. If the fundoplication loosens or fails, recent literature has shown promising long-term results from gastroesophageal dissociation (GED) compared with redo fundoplication. The video demonstrates the laparoscopic operation and the use of a robotics technique to ensure correct placement of sutures. Background: A retrospective review was performed on pediatric robot-assisted GED operations between October 2013 and July 2014 in our practice. Three robot-assisted GED were performed on pediatric patients, 3 to 11 years old. All patients had previous Nissen fundoplications with subsequent development of recurrent reflux symptoms and/or recurrent pneumonias. Minimally Invasive Method:...