FIELD: medicine.
SUBSTANCE: method involves carrying out video-assisted fundoplication with lesser omentum being mobilized. Omental bursa is entered. Right diaphragm pedicle is visualized. Esophagus mobilization begins with exposing medial fascicle of the right diaphragm pedicle. Gastrodiaphragmal ligament is retained as reference object separating the stomach into anterior and posterior wall. Esophagus is separated from posterior mediastinum and its abdominal position is restored. Esophagus and muscular loop mobilization is accomplished in moving behind the esophagus along the medial fascicle of the right diaphragm pedicle. Posterior stomach wall is approached at the lesser curvature side under the esophagus. Posterior stomach wall is moved behind the esophagus. Fundoplication collar is formed by attaching anterior and posterior stomach fundus walls to esophagus wall over some extent.
EFFECT: prevented esophagus rotation; enhanced abdominal position of the esophagus; avoided angular tension.
5 dwg
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