Abstract
ABSTRACT
Background:
A number of laparoscopic approaches and techniques have been described for children with gastroesophageal reflux. The most common techniques used for this type of surgery are the Nissen, the Toupet, and the Thal operations.
Patients and Methods:
We describe our experience with the laparoscopic Thal technique in 30 children (3 months–15 years) operated at the University Hospital in Münster and the Children's Hospital of Linz. Most of the children were neurologically impaired. A specially designed set of pediatric instruments was used.
Results:
No intraoperative complications occurred. Two open conversions were necessary because of severe adhesions from previous operations. The clinical follow-up shows a recurrence rate of 19% (3/28) proved by clinical and laboratory investigations. The follow-up time was 17 months to 5.1 years (mean 33.6 months).
Conclusions:
The laparoscopic operation is safe and normally followed by an uneventful postoperative course. Especially in multimorbid children with chest and spine deformities, the technique provides an excellent exposure of the hiatus and the fundus of the stomach. As other pediatric surgeons have reported, we have made the laparoscopic procedure our operation of choice for gastroesophageal reflux.
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