LAPAROSCOPIC REOPERATION ON FAILED ANTIREFLUX PROCEDURES - REPORT OF 2 PATIENTS

Two cases are presented that demonstrate the feasibility of using the laparoscopic transabdominal approach for failed antireflux procedures. The first patient had two previous Belsey hemifundoplications that ha d both failed and had intractable reflux unresponsive to conservative treatment, The Belsey operation was taken down and a floppy Nissen fun doplication performed; the patient had only transient postoperative dy sphagia. The second patient had a standard floppy Nissen fundoplicatio n performed over a large bougie and developed a postoperative motility problem that failed to respond to medication and dilation. The Nissen was taken down laparoscopically and converted to a Toupet procedure; the patient had total relief of the dysphagia. Neither patient had int ra-abdominal complications, and both have had total relief of their he artburn and regurgitation.