LAPAROSCOPIC TREATMENT OF FUNCTIONAL DISEASES OF THE ESOPHAGUS

The possibilities of laparoscopic surgery in the treatment of function al esophageal diseases (gastroesophageal reflux, achalasia and epiphre nic diverticula) are illustrated with special emphasis on the technica l aspects, including intraoperative complications and postoperative ca re, Results are discussed on the ground of the following experience. T hirty-seven laparoscopic fundoplications were performed with 13% conve rsion rate, 2.7% postoperative morbidity (1 slipped Nissen requiring r edo laparoscopic surgery), Median operative time was 140 min. One pati ent complained of dysphagia relieved by endoscopic dilation (2.7%), Al l patients are now asymptomatic after a median follow-up of 16 months although one has gastroesophageal reflux (GER) at 24-hrs pH monitoring , Forty laparoscopic Heller-Dor procedures: 7% conversions, 5% postope rative morbidity, Median duration 120 min, One patient complained of p ersistent dysphagia requiring endoscopic dilation (2.5%) and asymptoma tic GER was detected in 8% of patients, Finally, 2 patients underwent laparoscopic diverticulectomy, esophagomyotomy and Dor fundoplication without morbidity and excellent postoperative result, Laparoscopic tre atment of functional diseases of the esophagus is safe and effective, provided it is performed by an experienced surgeon with respect for so me important technical details, Further follow-up is needed to evaluat e long-term results.