Skip to main content
Erschienen in: Surgical Endoscopy 2/2013

01.02.2013

Laparoendoscopic single site (LESS) vs. conventional laparoscopic fundoplication for GERD: is there a difference?

verfasst von: Sharona Ross, Andy Roddenbery, Kenneth Luberice, Harold Paul, Thomas Farrior, Michelle Vice, Krishen Patel, Alexander Rosemurgy

Erschienen in: Surgical Endoscopy | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

This report details our experience with laparoendoscopic single site (LESS) fundoplication for GERD and provides a comparison to earlier contiguous patients undergoing conventional laparoscopic fundoplication.

Methods

With institutional review board approval, symptoms before and after LESS fundoplications and conventional laparoscopic fundoplications were scored by patients. Outcomes after 130 consecutive LESS fundoplications were compared to 130 contiguous consecutive outcomes after conventional laparoscopic fundoplications.

Results

Patients undergoing conventional laparoscopic vs. LESS fundoplication were very similar. There were no conversions to “open” operations and no notable complications with LESS fundoplication. Symptom reduction was broad and dramatic for patients undergoing LESS or conventional laparoscopic fundoplication; 96 % of patients who underwent LESS fundoplication scored their incision as ≥8 (1 = revolting to 10 = beautiful).

Conclusions

Relative to conventional laparoscopy, LESS surgery provides excellent resolution of symptoms without an apparent scar. In comparison to conventional laparoscopy, LESS fundoplication is as safe with similar symptom improvement and superior cosmesis.
Literatur
1.
Zurück zum Zitat Podolsky ER, Rottman SJ, Curcillo PG 2nd (2009) Single-port access (SPA) cholecystectomy: two-year follow-up. JSLS 13:528–535PubMedCrossRef Podolsky ER, Rottman SJ, Curcillo PG 2nd (2009) Single-port access (SPA) cholecystectomy: two-year follow-up. JSLS 13:528–535PubMedCrossRef
2.
Zurück zum Zitat Edwards C, Bradshaw A, Ahearne P, Dermatos P, Humble T, Johnson R, Mauterer D, Soosaar P (2010) Single-incision laparoscopic cholecystectomy is feasible: initial experience with 80 cases. Surg Endosc 24:2241–2247PubMedCrossRef Edwards C, Bradshaw A, Ahearne P, Dermatos P, Humble T, Johnson R, Mauterer D, Soosaar P (2010) Single-incision laparoscopic cholecystectomy is feasible: initial experience with 80 cases. Surg Endosc 24:2241–2247PubMedCrossRef
3.
Zurück zum Zitat Podolsky ER, Curcillo PG 2nd (2010) Single-port access (SPA) surgery: a 24-month experience. J Gastrointest Surg 14:759–767PubMedCrossRef Podolsky ER, Curcillo PG 2nd (2010) Single-port access (SPA) surgery: a 24-month experience. J Gastrointest Surg 14:759–767PubMedCrossRef
4.
Zurück zum Zitat Gumbs AA, Milone L, Sinha P, Bessler M (2009) Totally transumbilical laparoscopic cholecystectomy. J Gastrointest Surg 13:533–534PubMedCrossRef Gumbs AA, Milone L, Sinha P, Bessler M (2009) Totally transumbilical laparoscopic cholecystectomy. J Gastrointest Surg 13:533–534PubMedCrossRef
5.
Zurück zum Zitat Gill IS, Advincula AP, Aron M, Caddedu J, Canes D, Curcillo PG 2nd, Desai MM, Evanko JC, Falcone T, Fazio V, Gettman M, Gumbs AA, Haber GP, Kaouk JH, Kim F, King SA, Ponsky J, Remzi F, Rivas H, Rosemurgy A, Ross S, Schauer P, Sotelo R, Speranza J, Sweeney J, Teixeira J (2010) Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc 24:762–768PubMedCrossRef Gill IS, Advincula AP, Aron M, Caddedu J, Canes D, Curcillo PG 2nd, Desai MM, Evanko JC, Falcone T, Fazio V, Gettman M, Gumbs AA, Haber GP, Kaouk JH, Kim F, King SA, Ponsky J, Remzi F, Rivas H, Rosemurgy A, Ross S, Schauer P, Sotelo R, Speranza J, Sweeney J, Teixeira J (2010) Consensus statement of the consortium for laparoendoscopic single-site surgery. Surg Endosc 24:762–768PubMedCrossRef
6.
Zurück zum Zitat Chow A, Purkayastha S, Aziz O, Paraskeva P (2010) Single-incision laparoscopic surgery for cholecystectomy: an evolving technique. Surg Endosc 24:709–714PubMedCrossRef Chow A, Purkayastha S, Aziz O, Paraskeva P (2010) Single-incision laparoscopic surgery for cholecystectomy: an evolving technique. Surg Endosc 24:709–714PubMedCrossRef
7.
Zurück zum Zitat McCloy R, Randall D, Schug SA, Kehlet H, Simanski C, Bonnet F, Camu F, Fischer B, Joshi G, Rawal N, Neugebauer EA (2008) Is smaller necessarily better? A systematic review comparing the effects of minilaparoscopy and conventional laparoscopic cholecystectomy on patient outcome. Surg Endosc 22:2541–2553PubMedCrossRef McCloy R, Randall D, Schug SA, Kehlet H, Simanski C, Bonnet F, Camu F, Fischer B, Joshi G, Rawal N, Neugebauer EA (2008) Is smaller necessarily better? A systematic review comparing the effects of minilaparoscopy and conventional laparoscopic cholecystectomy on patient outcome. Surg Endosc 22:2541–2553PubMedCrossRef
8.
Zurück zum Zitat Hernandez JM, Morton CA, Ross S, Albrink M, Rosemurgy AS (2009) Laparoendoscopic single-site cholecystectomy: the first 100 patients. Am Surg 75:681–685PubMed Hernandez JM, Morton CA, Ross S, Albrink M, Rosemurgy AS (2009) Laparoendoscopic single-site cholecystectomy: the first 100 patients. Am Surg 75:681–685PubMed
9.
Zurück zum Zitat Osborne D, Boe B, Rosemurgy AS, Zervos EE (2005) Twenty-millimeter laparoscopic cholecystectomy: fewer ports results in less pain, shorter hospitalization, and faster recovery. Am Surg 71:298–302PubMed Osborne D, Boe B, Rosemurgy AS, Zervos EE (2005) Twenty-millimeter laparoscopic cholecystectomy: fewer ports results in less pain, shorter hospitalization, and faster recovery. Am Surg 71:298–302PubMed
10.
Zurück zum Zitat Hodgett SE, Hernandez JM, Morton CA, Ross SB, Albrink M, Rosemurgy AS (2009) Laparoendoscopic single-site (LESS) cholecystectomy. J Gastrointest Surg 13:188–192PubMedCrossRef Hodgett SE, Hernandez JM, Morton CA, Ross SB, Albrink M, Rosemurgy AS (2009) Laparoendoscopic single-site (LESS) cholecystectomy. J Gastrointest Surg 13:188–192PubMedCrossRef
11.
Zurück zum Zitat Hawasli A, Kandeel A, Meguid A (2010) Single-incision laparoscopic cholecystectomy (SILC): a refined technique. Am J Surg 199:289–293PubMedCrossRef Hawasli A, Kandeel A, Meguid A (2010) Single-incision laparoscopic cholecystectomy (SILC): a refined technique. Am J Surg 199:289–293PubMedCrossRef
12.
Zurück zum Zitat Rosmurgy AS, Donn N, Paul H, Luberice K, Ross SB (2011) Gastroesophageal reflux disease. Surg Clin N Am 91:1015–1029CrossRef Rosmurgy AS, Donn N, Paul H, Luberice K, Ross SB (2011) Gastroesophageal reflux disease. Surg Clin N Am 91:1015–1029CrossRef
13.
Zurück zum Zitat Golkar F, Morton C, Ross S, Vice M, Arnaoutakis D, Dahal S, Hernandez J, Rosemurgy A (2010) Medical comorbidities should not deter the application of laparoscopic fundoplication. J Gastrointest Surg 14:1214–1217PubMedCrossRef Golkar F, Morton C, Ross S, Vice M, Arnaoutakis D, Dahal S, Hernandez J, Rosemurgy A (2010) Medical comorbidities should not deter the application of laparoscopic fundoplication. J Gastrointest Surg 14:1214–1217PubMedCrossRef
14.
Zurück zum Zitat D’Alessio MJ, Rakita S, Bloomston M, Chambers CM, Zervos EE, Goldin SB, Poklepovic J, Boyce HW, Rosemurgy AS (2005) Esophagography predicts favorable outcome after laparoscopic Nissen fundoplication for patients with esophageal dysmotility. J Am Coll Surg 201:335–342PubMedCrossRef D’Alessio MJ, Rakita S, Bloomston M, Chambers CM, Zervos EE, Goldin SB, Poklepovic J, Boyce HW, Rosemurgy AS (2005) Esophagography predicts favorable outcome after laparoscopic Nissen fundoplication for patients with esophageal dysmotility. J Am Coll Surg 201:335–342PubMedCrossRef
15.
Zurück zum Zitat Ross SB, Villadolid D, Paul H, Al-Saadi S, Gonzalelz J, Cowgill SM, Rosemurgy A (2008) Laparoscopic Nissen fundoplication ameliorates symptoms of reflux, especially for patients with very abnormal DeMeester scores. Am Surg 74:635–642PubMed Ross SB, Villadolid D, Paul H, Al-Saadi S, Gonzalelz J, Cowgill SM, Rosemurgy A (2008) Laparoscopic Nissen fundoplication ameliorates symptoms of reflux, especially for patients with very abnormal DeMeester scores. Am Surg 74:635–642PubMed
16.
Zurück zum Zitat Hernandez J, Ross S, Morton C, McFarlin K, Dahal S, Golkar F, Albrink M, Rosemurgy A (2010) The learning curve of laparoendoscopic single-site (LESS) cholecystectomy: definable, short, and safe. J Am Coll Surg 211:652–657PubMedCrossRef Hernandez J, Ross S, Morton C, McFarlin K, Dahal S, Golkar F, Albrink M, Rosemurgy A (2010) The learning curve of laparoendoscopic single-site (LESS) cholecystectomy: definable, short, and safe. J Am Coll Surg 211:652–657PubMedCrossRef
17.
Zurück zum Zitat Huang CK, Tsai JC, Lo CH, Houng JY, Chen YS, Chi SC, Lee PH (2011) Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg 21:391–396PubMedCrossRef Huang CK, Tsai JC, Lo CH, Houng JY, Chen YS, Chi SC, Lee PH (2011) Preliminary surgical results of single-incision transumbilical laparoscopic bariatric surgery. Obes Surg 21:391–396PubMedCrossRef
18.
Zurück zum Zitat Solomon D, Bell RL, Duffy AJ, Roberts KE (2010) Single-port cholecystectomy: small scar, short learning curve. Surg Endosc 24:2954–2957PubMedCrossRef Solomon D, Bell RL, Duffy AJ, Roberts KE (2010) Single-port cholecystectomy: small scar, short learning curve. Surg Endosc 24:2954–2957PubMedCrossRef
19.
Zurück zum Zitat Binebaum SJ, Teixeira JA, Forrester GJ, Harvey EJ, Afthinos J, Kim GJ, Koshy N, McGinty J, Belsley SJ, Todd GJ (2009) Single-incision laparoscopic cholecystectomy using a flexible endoscope. Arch Surg 144:734–738CrossRef Binebaum SJ, Teixeira JA, Forrester GJ, Harvey EJ, Afthinos J, Kim GJ, Koshy N, McGinty J, Belsley SJ, Todd GJ (2009) Single-incision laparoscopic cholecystectomy using a flexible endoscope. Arch Surg 144:734–738CrossRef
Metadaten
Titel
Laparoendoscopic single site (LESS) vs. conventional laparoscopic fundoplication for GERD: is there a difference?
verfasst von
Sharona Ross
Andy Roddenbery
Kenneth Luberice
Harold Paul
Thomas Farrior
Michelle Vice
Krishen Patel
Alexander Rosemurgy
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 2/2013
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-012-2476-0

Weitere Artikel der Ausgabe 2/2013

Surgical Endoscopy 2/2013 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.