Laparoscopic reoperation following failed antireflux surgery

D. I. Watson, G. G. Jamieson, P. A. Game, R. S. Williams, P. G. Devitt

Research output: Contribution to journalArticlepeer-review

80 Citations (Scopus)



The aim was to determine the feasibility of laparoscopic revision surgery following previous open and laparoscopic antireflux operations.

The outcome was determined for 27 patients (14 men, 13 women) who had undergone attempted laparoscopic revision between 3 months and 25 years after a previous antireflux operation. Median follow‐up was 12 (range 3–48) months.

Thirteen patients had previously had an open antireflux procedure (Nissen fundoplication, seven; transthoracic anatomical repair, five; Belsey procedure, one) and 14 a laparoscopic procedure (Nissen, 12; anterior partial fundoplication, two). The indications for revision were: recurrent reflux, 15; paraoesophageal hiatus hernia, six; troublesome dysphagia, six. Fifteen procedures comprised construction of a new Nissen fundoplication, six conversion from a Nissen to a partial wrap, three repair of a paraoesophageal hernia and three widening of the oesophageal hiatus. Revision was successfully completed laparoscopically in 12 patients following a previous laparoscopic procedure and in nine following a previous open operation. Median operating time was 105 min after previous open surgery and 80 min after laparoscopic surgery. No perioperative complications occurred in either group and a good outcome was achieved in 25 of the 27 patients.

Laparoscopic reoperative antireflux surgery is feasible. Reoperation is likely to be more difficult following failure of an open procedure than a laparoscopic one.
Original languageEnglish
Pages (from-to)98-101
Number of pages4
JournalBritish Journal of Surgery
Issue number1
Publication statusPublished - 1 Jan 1999
Externally publishedYes


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