Minimal access surgery for gastroesophageal reflux: laparoscopic placement of the Angelchik prosthesis in pigs |
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Authors: | R Berguer G V Stiegmann M Yamamoto J Kim A Mansour J Denton L W Norton J P Angelchik |
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Institution: | (1) Department of Surgery, University of Colorado Health Science Center, 80262 Denver, CO, USA;(2) Denver Veterans Administration, 80262 Denver, CO, USA;(3) Phoenix Baptist Hospital, 80262 Denver, CO, USA;(4) Department of Surgery, University of Colorado Health Science Center, 4200 East 9th Avenue, Box C-313, 80262 Denver, CO, USA |
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Abstract: | Summary Conventional surgery for gastroesophageal reflux is effective but requires laparotomy. Minimal access surgery for gastroesophageal
reflux could provide a decrease in morbidity. The Angelchik antireflux prosthesis is an alternative to fundoplication for
the treatment of this ailment. We evaluated the results of laparoscopic placement of the Angelchik prosthesis in 10 pigs.
The duration of the procedure averaged 44 min. The mean lower esophageal sphincter pressure increased from 12.2 ±2.8 mmHg
at baseline to 45.2±7.8 (P <0.05), 32.1 ±3.9 (P<0.05), and 25.1 ±6.5 mmHg (P >0.05) as measured immediately postoperatively, at 1 week, and at 3 weeks, respectively, following placement of the prosthesis.
There was no instance of prosthetic migration or esophageal perforation. One postoperative death due to distention and perforation
of the colon occurred. Two animals developed distal esophageal impaction of food. We conclude that the antireflux prosthesis
can be safely and effectively placed using laparoscopic methods in a porcine model. Further development of this technique
is warranted. |
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Keywords: | Gastroesophageal reflux Angelchik prosthesis Laparoscopy Pig Esophageal manometry Lower esophageal sphincter |
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