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J Laparoendosc Adv Surg Tech A · Dec 2015
Case ReportsSurgical Technique for Laparoscopic Removal of a Magnetic Lower Esophageal Sphincter Augmentation Device.
- Jamil L Stetler, Sujata Gill, Ankit Patel, S Scott Davis, and Edward Lin.
- Division of General and Gastrointestinal Surgery, Emory University , Atlanta, Georgia .
- J Laparoendosc Adv Surg Tech A. 2015 Dec 1; 25 (12): 1025-8.
BackgroundNissen fundoplication is the current gold standard for surgical management of gastroesophageal reflux disease; however, a magnetic antireflux device is now an alternative surgical procedure. The early literature shows good reflux control with minimal complications, and therefore placement of these devices is growing in popularity. As more of these devices are placed, there will be cases in which they will need to be removed. A laparoscopic method for removing the device is presented here.Materials And MethodsWe present a case of a 42-year-old female with history of gastroesophageal reflux who underwent a laparoscopic placement of a magnetic lower esophageal sphincter augmentation device and repair of a small hiatal hernia. She had a complicated postoperative course before presenting to our institution with a 2-year history of persistent dysphagia and requesting the device be removed. Laparoscopic removal of the device was performed.ResultsAfter laparoscopic removal of the patient's magnetic lower esophageal sphincter augmentation device, she had subjective improvement in her dysphagia but is now being medically managed for gastroesophageal reflux and for delayed gastric emptying.ConclusionsLaparoscopic removal of magnetic lower esophageal sphincter augmentation devices will sometimes be necessary and may be challenging if the surgeon encounters significant scar tissue around the gastroesophageal junction. Postoperative complications are similar to those encountered with foregut surgeries and include postoperative delayed gastric emptying.
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