Gastroesophageal Reflux Disease (GERD) is a common disease, affecting 10% of the general population and an increase in its incidence has been observed. From January 1993 to March 1998, 112 patients were submitted for the treatment of reflux esophagitis by fundoplication and hiatoplasty using videolaparoscopy. Sixty two (55.3%) were male and 50 were female (44.7%). The mean age was 40 years old, ranging from 20 to 90 years. 1ndication for surgery was a GERD refractory to clinical treatment (76,8%), followed by Barrett's esophagus (16%), esophageal stenosis (3.5%), esophageal ulcer with upper digestive tract hemorrhage (2.6%) and paraesophageal hiatal hernia (0.9%). Five trocars were used for each surgical procedure. The hiatoplasty was performed with 00 cotton sutures, wrapping with an X both arms of diaphragmatic pillars. For the fundoplication, after the transposition of the gastric fundus behind the abdominal portion of the esophagus, an initial suture is set on the two gastric extremities of the anterior wall, without passing through the esophagus, however: Then, another four sutures were ser, two above and two below the initial one, in order to wrap the esophagus, on a partial manner (270(0)). Mean surgical time was 80 minutes and mean hospital stay was 1.8 days. There were two conversions (1.7%). There was no mortality; complications noted were pneumothorax (0.9%), subcutaneous enfisema (0.9%), transient dysphagia (26%) and persistent dysphagia (3.5%). We have shown that laparoscopic mixed fundoplication is a safe and effective procedure for the definitive treatment of GERD, by adding the advantages of a simplífied surgical technique with a low incidence of complications.
Laparoscopic fundoplication; Reflux esophagitis; Hiatal hernia