482. REFLUXSTOP PROCEDURE IN THE LAPAROSCOPIC REPAIR OF HIATAL HERNIA

IF 2.3 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Diseases of the Esophagus Pub Date : 2024-09-02 DOI:10.1093/dote/doae057.222

Joerg Zehetner

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Abstract

The video demonstrates laparoscopic anti-reflux surgery with the RefluxStop procedure, first introduced in 2016 and now offered in multiple centers across Europe. As this tertiary level hospital was among the first to offer this treatment to patients in clinical practice, this video provides unique insight to the lessons learned from the early experience of this surgery, with regard to optimizing effectiveness and safety. In light of the promising clinical outcomes that are emerging as follow-up data become available, the number of surgeons performing this this technique is likely to continue to increase. The RefluxStop procedure addresses all 3 components of the anti-reflux barrier as follows: 1) laparoscopic hiatal hernia repair, 2) high mediastinal dissection to achieve 4-6 cm intraabdominal length of esophagus, allowing the LES to be brought into an optimal intraabdominal position, and 3) recreation of the flap valve at the angle of His though creation of a 90-degree esophago-gastric plication. The 22mm round silicone RefluxStop device is then positioned high-up and close to the esophagus in a fundic pocket, to maintain the correct position of the repair. https://drive.google.com/file/d/1hlXXRUUMkDPmheW_mgPM_g1wWCu2R_Y3/view

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482.腹腔镜食管裂孔疝修补术中的反流止血术

该视频演示了采用 RefluxStop 手术的腹腔镜抗反流手术，该手术于 2016 年首次推出，目前已在欧洲多个中心提供。由于这家三级医院是首批在临床实践中为患者提供这种治疗方法的医院之一，本视频提供了独特的视角，介绍了从早期手术经验中吸取的有关优化有效性和安全性的经验教训。鉴于随访数据显示出的良好临床效果，实施这项技术的外科医生人数可能会继续增加。RefluxStop 手术可解决抗反流屏障的所有 3 个组成部分，具体如下：1）腹腔镜食管裂孔疝修补术；2）纵隔高位解剖，使食管腹腔内长度达到 4-6 厘米，从而将 LES 置于腹腔内的最佳位置；3）通过创建 90 度食管-胃瓣膜，在 His 角处重建瓣膜。然后，将 22 毫米圆形硅酮 RefluxStop 装置置于高处，靠近食道的胃底袋中，以保持修复的正确位置。https://drive.google.com/file/d/1hlXXRUUMkDPmheW_mgPM_g1wWCu2R_Y3/view。

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