Complications of laparoscopic antireflux surgery

Over the last decade. the laparoscopic approach to antireflux surgery has b een widely applied, resulting in improved early outcomes and greater patien t acceptance of surgery for gastroesophageal reflux disease. However, altho ugh short-term outcomes are probably better overall than those following op en surgery, it has become apparent that the laparoscopic approach is associ ated with an increased risk of some complications, and as well as the occur rence of new complications specific to the laparoscopic approach. Significa nt complications include acute paraesophageal hiatus herniation, severe dys phagia, pneumothorax, vascular injury, and perforation of the gastrointesti nal tract. The incidence of some of these complications decreases as surgeo ns gain experience; others can be minimized by using an appropriate operati ve technique. In addition, laparoscopic reintervention is usually straightf orward in the Ist postoperative week. For this reason, the surgeon should h ave a low threshold for early laparoscopic reexploration, facilitated by ea rly radiological contrast studies, in order to reduce the likelihood that p roblems will arise later.