LAPAROSCOPIC SURGERY FOR HIATAL-HERNIA AND PEPTIC-ULCERATION

Antireflux and peptic ulcer surgery are ideally suited for the minimal access approach. There is no need for tissue retrieval, nor any compr omise of surgical principles. Over the last five years there has been a tremendous expansion in both the number and types of these laparosco pic procedures and there is little doubt that minimal access antireflu x surgery is here to stay. Medical therapy is expensive and laparoscop ic surgery, with a reduction in pain, hospital stay and rehabilitation has become an economic alternative with the most commonly performed p rocedure being the Nissen fundoplication. Peptic ulcer surgery has bee n slower to develop. The economic argument is not as powerful and it i s unlikely that we will see much increase in laparoscopic surgical tre atment except for complications such as perforation, stenosis and blee ding. As yet, series are relatively small with early results and we aw ait with interest the long-term results.