LaparoscopyTeflon pledget reinforced fundoplication causes symptomatic gastric and esophageal lumenal penetration
Section snippets
Methods
A prospective computer based record has been kept of all patients operated on by the senior author; patient details being recorded by a data manager on a Microsoft database and Excel spreadsheet. All fundoplications both laparoscopic and operation are recorded individually. Hospital operation records were also reviewed for each case. A review of the literature using the Medline and Pub Med search engines was conducted, using the terms “fundoplication, postoperative complications, pledget,
Results
Symptomatic lumenal penetration of Teflon pledgets to this date has occurred in 11 patients from a total of 1,175 cases in our database, (an incidence of less than 1%). Patients suffering the complication ranged in age from 41 to 74 years with an average age of 55.8 years. There were 6 men (average age 53.2 years) and 5 women (average age 58.8 years). No common factor predisposing these patients to pledget erosion was identified.
Comments
The Teflon pledget buttressed fundoplication was performed with the view to prevent recurrence by reinforcing the wrap using a modification of the technique described in the literature by DeMeester [6]. An earlier paper by DeMeester [9] compared open fundoplication with medical treatment for gastroesophageal reflux and followed up 34 patients with pledget reinforced fundoplication for 2 years. No problems with pledget erosion were documented. Hinder et al [6] also used this technique in their
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