Laparoscopic modified Thal fundoplication for gastroesophageal reflux in a patient with severe scoliosis and sliding esophageal hiatal hernia.

Abstract

A 14-year-old girl with severe scoliosis and sliding esophageal hiatal hernia underwent laparoscopic fundoplication for gastroesophageal reflux. Of various fundoplication procedures, anterior partial fundoplication (Thal fundoplication) was performed because it is effective, with less postoperative gas bloat syndrome. Laparoscopic fundoplication in severely scoliotic children could allow improved operative visibility and easier access to the hiatus in comparison with the open approach. In our "modified anterior partial fundoplication," the sutures between the crura and the esophagus and the sutures on the left of esophageal wall with the fundus of the stomach could be exactly performed by laparoscopic surgical technique. The wrapping of the esophagus in fundoplication was done over the ventral 180 degrees to 270 degrees. Six months postoperatively, the patient did not develop gas bloat syndrome, distal esophageal obstruction from fundoplication, and delayed gastric emptying. Modified anterior partial fundoplication achieves effective control of reflux symptoms.

• Authors: Yukihiro Tatekawa, Hiromichi Kanehiro, Yoshiyuki Nakajima
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 41 Issue 10 Pg. E15-8 (Oct 2006) ISSN: 1531-5037 [Electronic] United States
• PMID: 17011252 (Publication Type: Case Reports, Journal Article)

Topics

• Adolescent
• Esophageal Diseases (complications, pathology)
• Female
• Fundoplication (methods)
• Gastroesophageal Reflux (complications, diagnostic imaging, surgery)
• Hernia, Hiatal (complications, pathology)
• Humans
• Laparoscopy
• Radiography
• Scoliosis (complications, physiopathology)
• Severity of Illness Index
• Treatment Outcome