LAPAROSCOPIC REDO NISSEN FUNDOPLICATION

Nine patients underwent redo laparoscopic Nissen fundoplication becaus e of failed primary laparoscopic antireflux procedure. Symptoms prior to reoperation included heartburn (n = 5), dysphagia (n = 2), dysphagi a and heartburn (n = 1), and early satiety and epigastric pain (n = 1) , Endoscopic and radiologic findings prior to reoperation included eso phagitis (n = 6), reflux (n = 6), stenosis (n = 2), and hiatal hernia (n = 1). Findings at reoperation included fundoplication positioned on the stomach (n = 5); a disrupted cruroplasty (n = 1); gastric volvulu s (n = 1); and an excessively tight wrap (n = 1) or cruroplasty (n = 1 ). Reconstruction of the fundoplication was performed according to acc epted principles for this procedure. All patients were discharged with in 2 days after the redo procedure. Follow-up time is 4-14 months, Pre operative symptoms were relieved in all patients and all antireflux me dication have been discontinued. Routine postoperative esophagram and endoscopy demonstrated intact repair and without gastroesophageal refl ux or stenosis, Reoperative laparoscopic Nissen fundoplication is feas ible and effective.