Minimally invasive antireflux surgery: High volume center experience of first 550 cases

Abstract

Introduction: Thus paper is a presentation of a ten-year experience of minimally invasive antireflux surgery by a surgical team in a highly specialized center. Materials and Methods: An observational retrospective clinical study with prospective follow-up was conducted, including consecutively operated patients who underwent minimally invasive surgery for gastroesophageal reflux disease (GERD) and giant hiatus hernia (GHH). The research was carried out at the Esophageal Surgery Center, Digestive Surgery Clinic, University Clinical Center of Serbia, from January 2010 to January 2020. Comprehensive preoperative and intraoperative findings, surgical procedures, and postoperative monitoring details are presented. Results: In total, 550 consecutive patients were included in the study. Minimally invasive antireflux surgery was performed in 260 patients for GERD, while surgery for giant hiatus hernia (GHH) and its subgroup involving intrathoracic gastric positioning was conducted in 184 and 106 patients, respectively. There were no conversions to open procedures. Pneumothorax occurred in 21 patients as a result of intraoperative pleural injury. Two patients required re-intervention due to port-site bleeding. Short-term and long-term follow-up outcomes are highly satisfactory and have been presented in detail. Conclusion: The introduction and implementation of minimally invasive antireflux surgery, when properly executed within a highly specialized center, can lead to a low incidence of complications and highly satisfactory short-term and long-term functional outcomes.