Hg. Baladas et al., Esophagogastric fistula secondary to teflon pledget: a rare complication following laparoscopic fundoplication, DIS ESOPHAG, 13(1), 2000, pp. 72-74
Laparoscopic fundoplication has become the standard operation for gastroeso
phageal reflux disease. In our service, a laparoscopic fundoplication is pe
rformed as a 2-cm floppy 360 degrees wrap with division of the short gastri
c vessels and the fundoplication is sutured using a prolene 2/0 mattress su
ture (Ethicon, USA) and buttressed laterally with two teflon pledgets (PTFE
1.85 mm; low porosity, Bard, USA). We report a patient with post-operative
dysphagia due to an esophagogastric fistula caused by erosion of a teflon
pledget. This is the first such case in 734 laparoscopic fundoplications pe
rformed between January 1991 and December 1998. Reoperation was required, r
esulting in a prolonged convalescence. A review of current literature has n
ot revealed any similar cases. Causes for this rare complication are postul
ated.