ABSTRACT
Numerous reports detail the benefits of laparoscopic fundoplication, including decreased pain, quicker return to normal daily activities, and shorter hospital stay. However, there are also complications related to the treatment of gastroesophageal reflux disease (GERD). Mortality reports range from zero to two per cent for initial repairs, increasing to five per cent for second operations.1,2 The morbidity, and likewise failure, of laparoscopic fundoplication is dependent on its definition and length of follow-up. Most large, single-institution studies report morbidities of two to 26 per cent, with specific identification of failed surgery occurring in four to eight per cent.2-4 Table 32.1 displays the reported causes and frequencies of these failures (see also Chapter 29). This chapter discusses the more common intraoperative and postoperative complications associated with laparoscopic fundoplication, their prevention, the appropriate work-up for their diagnosis, and the appropriate course of action. In addition, any reoperation, whether laparoscopic or open, is known to have a higher incidence of complications as well as a higher risk of recurrence.5-7 It should be stressed that conversion from a laparoscopic to open surgery for patient safety should not be considered a complication if performed at the appropriate time.
