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OBJECTIVE The authors laparoscopic approach for a Nissen fundoplication is presented. SUMMARY BACKGROUND DATA The technique has been undertaken in 155 patients over 29 months, with 137 patients having been observed for more than 3 months. METHODS Three hundred sixty degree fundoplication was undertaken using three or four sutures to secure the wrap.(More)
Postoperative paraoesophageal hiatus hernia occurred in 17 of 253 patients who underwent laparoscopic fundoplication at five different hospitals. Ten patients have undergone subsequent surgical revision, eight by an open technique and two by laparoscopy. This complication may have important implications for the technique of laparoscopic fundoplication, as(More)
BACKGROUND Acute paraesophageal hernia is a surgical emergency presenting with sudden chest or abdominal pain, dysphagia, vomiting, retching or significant anemia. Severe cases can present with respiratory failure or systemic sepsis. This can be due to gastric volvulus, incarceration, strangulation, severe bleeding or perforation. Traditionally this has(More)
BACKGROUND There is increasing interest in using simulators for laparoscopic surgery training, and simulators have rapidly become an integral part of surgical education. METHODS We searched MEDLINE, EMBASE, Cochrane Library, and Google Scholar for randomized controlled studies that compared the use of different types of simulators. The inclusion criteria(More)
BACKGROUND Laparoscopic splenectomy (LS) has become a safe and feasible procedure for cases involving spleens of normal size. Only a few publications report on the outcome of LS with preoperative splenic artery embolization (SAE) for massive splenomegaly. The authors present their experience in patients with massive splenomegaly who underwent(More)
During laparoscopic dissection of the oesophagus, the left pleura is easily breached, resulting in pneumothorax. This complication has not been widely reported, although it is likely to be common. Management depends on subsequent cardiorespiratory effects, which are variable. Five cases are reported from an initial experience of 190 laparoscopic Nissen(More)
OBJECTIVE To evaluate early experience with laparoscopic Heller's cardiomyotomy with placement of a Dor patch for achalasia. DESIGN A prospective case series. SETTING A university teaching hospital. PATIENTS Fourteen patients (5 men, 9 women, median age 47 years) with esophageal achalasia, treated between July 1992 and July 1994. INTERVENTIONS(More)