Copyright â Springer-2015
Part I: The Basics of GERD
1: Surgical Anatomy of the Esophageal Hiatus
Exposing the Esophageal Hiatus
The Gastroesophageal Junction
Vascular Anatomy for Foregut Surgery
2: Effects of Reflux on the Esophageal Mucosa
The Offense: Gastric Contents
Helicobacter pylori Infection
Acid Suppressive Drug Therapy
The Defense: The Lower Esophageal Sphincter
Definition of Normal Esophagus and Gastroesophageal Junction
The Target: The Esophageal Squamous Epithelium
Reflux-Induced Damage to Esophageal Squamous Epithelium
Structural Cellular Changes
Biopsy Diagnosis of Reflux Esophagitis
Effect of Acid Suppressive Drug Therapy on Squamous Epithelium
Effect of Acid Suppressive Drug Therapy on Metaplastic Esophageal Columnar Epithelium
Metaplastic Esophageal Columnar Epithelial Types
The Amount (Length) of the Squamo-Oxyntic Gap
Cause of Intestinal Metaplasia in Columnar Epithelia
Distribution of Columnar Epithelia in the Squamo-Oxyntic Gap
Carcinogenesis in Columnar Lined Esophagus
Effect of Anti-reflux Surgery on Esophageal Epithelia
3: Epidemiology and Socioeconomics of Reflux Disease
Epidemiology of Gastroesophageal Reflux Disease
Economics of Gastroesophageal Reflux
Personal Cost to Patients
Costs to Healthcare Systems
Effects on Work and Productivity
Epidemiology of Barrett’s Esophagus
4: Medical Therapy for GERD
Unexplained Chest Pain (Non-cardiac Chest Pain)
5: Indications for Antireflux Surgery
Pre-operative Predictors of Surgical Outcomes
Typical and Atypical Symptoms
Non-erosive and Erosive Reflux Disease
Medical and Surgical Treatment for GERD: Randomized Trials
6: The Relation of Hiatal Hernia to Gastroesophageal Reflux Disease
Clinical Significance of Hiatal Hernia
The Role of the Crural Diaphragm in Reflux
Maintaining Closure of the GEJ
Reduce Gastric Reflux Flow and Volume
Impaired Esophageal Acid Clearance and Re-reflux
7: The Lower Esophageal Sphincter
Location, Anatomy, and Embryology of the Lower Esophageal Sphincter
The Role of the Diaphragmatic Crura
8: Preoperative Evaluation and Testing for GERD
Hiatal or Paraesophageal Hernia
Esophagogastroduodenoscopy (EGD) and Biopsy Protocol
Performing a Pre-surgical EGD
Esophageal Function Testing
Esophageal Water-Perfused Motility
Catheter Based 24 h pH Monitoring
High-Resolution Manometry
Multichannel Intraluminal Impedance
Part II: Techniques of Antireflux Surgery
9: Complete Fundoplications: Indications and Technique
Patient Selection for Nissen
10: Posterior Partial Fundoplications: Indications and Technique
Patients with Esophageal Dysmotility
Perioperative Complications
11: Anterior Partial Fundoplications: Indications and Technique
Construction of an Anterior 180° Partial Fundoplication
Hiatal Dissection and Repair
Construction of an Anterior 90° Partial Fundoplication
12: Paraesophageal Hernia: Indications and Technique
Etiology and Pathogenesis
Incidence and Classification
Upper Gastrointestinal Contrast Study
Laparoscopic Operative Technique
Access and Trocar Placement
13: The Hill Antireflux Operations Repair and Its Variants
Advantages of the Hill Repair
Results of the Hill Repair
The Nissen
Hill Hybrid Repair
Nissen
Hill Hybrid Technique
Completion of the Hill Sutures
Placement of Hill Sutures
Results of the Hybrid Repair
14: Endoscopic Therapies for Reflux Disease
Implantation of Synthetic Bulking Agents at the LES
Radiofrequency Burns oft the LES
Transoral Suturing and Plication
Bard EndoCinch Gastroplication Device (Bard Endoscopic Technologies, Billerica, MA)
NDO Surgical Endoscopic Plication System (NDO Surgical, Inc., Mansfield, MA)
Wilson-Cook Endoscopic Suturing Device (ESD; Wilson-Cook Medical Inc, Winston-Salem, NC)
ARD Syntheon (Syntheon, Miami, FL)
MUSE Device (Medigus, Omer, Israel)
Transoral Incisionless Fundoplication
Current Status and Future Prospective for EAR
15: Magnetic LES Augmentation: The LINX Procedure
The LINX Reflux Management System
Why a New Antireflux Procedure?
How to Identify the Patient for Sphincter Augmentation
16: GERD Treatment in the Bariatric Population
GERD and the Obese Patient
Bariatric Surgery Options
Treating Refractory GERD After Bariatric Surgery
17: Perioperative Complications and Their Management
Part III: Controversies in Reflux Surgery
18: The Use of Mesh in Hiatal Hernia Repair
Operative Approach: Historical Perspective
Operative Technique; Mesh Overlay
Operative TechniqueDifficult Closures
Operative TechniqueIncorporated Mesh Implantation
Recommendations and Conclusion
Mediastinal Dissection and Esophageal Mobilization
Preoperative Planning and Operative Setup
Stapled-Wedge Gastroplasty
Combined Laparoscopic
Thoracoscopic Collis Gastroplasty
Crural Closure and Fundoplication
Long-Term Follow-Up and Outcomes
20: Poor Esophageal Motility: A Tailored Approach?
Defining Poor Esophageal Motility
High-Resolution Manometry
The Tailored Approach in the Current Literature
Outcome of Partial Fundoplication
Partial vs Complete Fundoplication in the Presence of IEM
IEM Versus Normal Motility
21: Delayed Gastric Emptying and Reflux Disease
Laparoscopic Pyloroplasty
Feeding Tube and Gastrostomy Tube Placement
GERD in Obese Gastroparetic Patients
Gastroparesis as a Complication of Antireflux Surgery
Gastroparesis Refractory to Pyloroplasty
22: Reoperative Antireflux Surgery
Need for Reoperation and Patterns of Failure
Early Versus Late Failure
Establishing the Diagnosis
Planning for Operative Management
Intraoperative Management
Outcomes of Reoperative Antireflux Surgery
Mesh at the Esophageal Hiatus
Recurrent Hiatal Hernia and Short Esophagus
Redo After Prior Endoluminal Antireflux Procedure
Part IV: Outcomes Following ARS
23: Side Effects of Fundoplications and How to Deal with Them
Antireflux Barrier and Fundoplication
Acute Postoperative Dysphagia
Postoperative Gas-Related Symptoms
24: Outcomes of Antireflux Surgery
Evolution of Antireflux Surgery
Postoperative Complications
Long-Term Outcomes of Laparoscopic Antireflux Surgery
Heartburn, Regurgitation, and Bloating
Antireflux Medication Utilization Following Surgery
Failure Rates and Reoperation
Comparing LARS to Long-Term PPI Therapy
Patient Selection for Antireflux Surgery
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