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Ann Thorac Surg 1995;60:921
© 1995 The Society of Thoracic Surgeons

Discussion

Discussion

The first 20% of the full text of this article appears below.

See also page 915.

DR NICHOLAS J. DEMOS (Jersey City, NJ): I was delighted to hear the outstanding work of Drs Pera, Duranceau, and associates.

In 1974 at the New York Society for Thoracic Surgery I presented the experimental basis of this procedure and the first cautious clinical application. Since then I have performed 145 stapled uncut gastroplasties and fundoplication with only two possible recurrences.

The procedure we are discussing now may also be performed for short esophagus. The stomach can be stapled 5 or 6 cm below the cardia and the plication done and comfortably sutured under the diaphragm. Moreover, in the aperistaltic or dyskinetic esophagus a partial plication is performed after the stapling, and the sutures are taken only on the gastric wall. No sutures are taken on the fragile esophageal wall.

In the last three years I have performed this procedure thoracoscopically with the video-assisted thoracoscopic surgical technique, to the dismay of some members here today. You need only four portals to do the operation: one for the camera, one for the lung retractor, and two working channels. You need only one assistant to hold the thoracoscopic camera, and of course you do not have to use CO2 insufflation in the chest as people do . . . [Full Text of this Article]


Related Article

Uncut Collis-Nissen Gastroplasty: Early Functional Results
Manuel Pera, Claude Deschamps, Raymond Taillefer, and André Duranceau
Ann. Thorac. Surg. 1995 60: 915-920. [Abstract] [Full Text]





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