Stricturoplasty and Intrathoracic Fundoplication

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Intrathoracic fundoplications were used for the shortened esophagus by Krupp and Rossetti57 in 1966. They completed a total fundoplication around the lower esophagus and left the repair in the chest. The same type of repair was subsequently used by Woodward as reported by Maher et al.58 In their review of this technique, they reported good to excellent results in 82% of their patients. An important step that needs to be added to this technique is the essential detail of widening of the diaphragmatic hiatus

Collis Fundoplasty

Figure 13.7. Transverse closure of the fundus for the modified Collis-Nissen fundoplasty provides substantial additional fundic tissue, enabling creation of a total or partial wrap around the extended esophageal tube without tension. (Reprinted from Ferraro P, Duranceau A. Elongation gastroplasty with total fundoplication. Operative Techniques in General Surgery 200;2:24-37, Copyright 2000, with permission from Elsevier.)

Figure 13.7. Transverse closure of the fundus for the modified Collis-Nissen fundoplasty provides substantial additional fundic tissue, enabling creation of a total or partial wrap around the extended esophageal tube without tension. (Reprinted from Ferraro P, Duranceau A. Elongation gastroplasty with total fundoplication. Operative Techniques in General Surgery 200;2:24-37, Copyright 2000, with permission from Elsevier.)

MANAGING FAILED ANTI-REFLUX THERAPY

fundoplications: paragastric hernias, gastric ulcerations, and gastric fistulization with medi-astinal structures.

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