Search Our Scientific Publications & Authors

Gan To Kagaku Ryoho 2019 Jan;46(1):65-69

Dept. of Digestive Surgery, Saku Central Hospital Advanced Care Center.

A 69-year-old man with chronic gastritis, reflux esophagitis, esophageal hiatal hernia, and history of appendicitis surgery complained of difficulty swallowing. Upper gastrointestinal endoscopy revealed a 10 cm sized Type 3 gastric cancer. Immunostaining was positive for chromogranin A(2+), synaptophysin(3+), CD56(-), and Ki-67>70%. Read More

Chirurg 2019 Feb 13. Epub 2019 Feb 13.

Klinik für Allgemein-, Viszeral- und Tumorchirurgie, Universitätsklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.

Abdom Radiol (NY) 2019 Feb 12. Epub 2019 Feb 12.

Division of Interventional Radiology, Department of Radiology, University of California Los Angeles, 757 Westwood Plaza, Los Angeles, CA, 90095, USA.

Purpose: To report the transnasal stent-assisted targeting technique for percutaneous jejunostomy placement in patients with hiatal hernias.

Materials And Methods: Four patients, including three (75%) females and one (25%) male, with mean age of 77.5 years (range 73-78 years), and with a hiatal hernia and intrathoracic stomach precluding gastrostomy placement and loop snare placement into the mid-jejunum underwent the transnasal stent-assisted targeting technique for percutaneous jejunostomy placement. Read More

Am Surg 2018 Nov;84(11):1819-1824

Surgery for refractory gastroesophageal reflux disease (GERD) has a satisfactory outcome for most patients; however, sometimes redo surgery is required. The Outcome and morbidity of a redo are suggested to be less successful than those of primary surgery. The aim of this study was to describe our experience, long-term results, and complications in redo surgery. Read More

Am Surg 2018 Nov;84(11):1762-1767

We have recently introduced laparoscopic magnetic sphincter augmentation (MSA) combined with hiatal hernia repair for treatment of patients with medically refractory gastroesophageal reflux disease (GERD). MSA is a novel surgical approach to the treatment of severe GERD, in which magnetic beads are secured around the lower esophageal sphincter, augmenting the lower esophageal sphincter function as an anti-reflux barrier. We hypothesize that patients undergoing MSA will achieve GERD relief, equal to that obtained after laparoscopic Nissen fundoplication. Read More

J Gastrointest Surg 2019 Feb 7. Epub 2019 Feb 7.

Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA.

Background: Anti-reflux mucosectomy (ARMS) is a relatively new endoscopic procedure for gastroesophageal reflux disease (GERD). A hemi-circumferential endoscopic mucosal resection (EMR) is performed around the gastroesophageal junction (GEJ), which then contracts and tightens during healing. The aim of this study was to assess the feasibility and safety of the procedure. Read More

Obes Surg 2019 Feb 5. Epub 2019 Feb 5.

Department of Gastro-Intestinal Surgery, Elisabeth-TweeSteden Hospital, Dr. Deelenlaan 5, 5042 AD, Tilburg, the Netherlands.

This study reviews a single institution's experience with simultaneous (redo) laparoscopic Roux-en-Y gastric bypass (LRYGB) and primary large paraesophageal hernia (PEH) repair. A retrospective review was done of all 13 patients who underwent simultaneous LRYGB and large PEH repair between February 2014 and December 2017 at our institution. All patients had a large type III or IV PEH. Read More

ANZ J Surg 2019 Jan 30. Epub 2019 Jan 30.

Department of Surgery, Shoalhaven District Memorial Hospital, Nowra, New South Wales, Australia.

Background: Symptomatic para-oesophageal hiatus (PEH) hernias are treated by surgical intervention, and are associated with older age (>50 years) and higher body mass index (>25 kg/m ). Both risk factors are increasing within the Australian population. Given these trends, this study aimed to determine if the rate of PEH repair is increasing within Australia. Read More

Hernia 2019 Jan 25. Epub 2019 Jan 25.

Department of Surgery, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria.

Purpose: This study investigates if pledgeted sutures for hiatal closure could be an alternative to mesh for the surgical treatment of large hiatal hernia.

Methods: Forty-one patients who underwent laparoscopic 270° Toupet fundoplication with pledgeted sutured crura between September 2014 and April 2017 were evaluated with regard to recurrence of hiatal hernia at 3 months and 1 year after surgery. Indication for pledgets was a hiatal surface area of at least 5. Read More

Dig Dis Sci 2019 Jan 25. Epub 2019 Jan 25.

Catholic Photomedicine Research Institute, Seoul St. Mary's Hospital, The Catholic University of Korea, 505, Banpo-dong, Seocho-gu, Seoul, 137-070, Korea.

Background And Aims: A prototype of a disposable endoscope (DE) with easy viewing of the esophagus has been developed. The aim of this study was to develop a new version of DE with improved functionality and to assess the feasibility of DE as a screening tool for upper gastrointestinal diseases compared with conventional endoscopes.

Methods: Diagnostic accuracy and maneuverability of DE were evaluated by comparing endoscopy using DE with conventional endoscopy. Read More

Surg Endosc 2019 Jan 23. Epub 2019 Jan 23.

Division of General Surgery and Bariatric Centre of Excellence, Department of Medical-Surgical Sciences and Biotechnologies, University of Rome "La Sapienza", Rome, Italy.

Purpose: The aim of the present paper is to report the results of a single institution series of hiatal hernia repair (HHR) with augmented mesh hiatoplasty focusing on safety and efficacy profile of Bio-A absorbable synthetic mesh.

Materials And Methods: A retrospective evaluation of prospectively maintained database showed 120 consecutive patients submitted to HHR reinforced with bio-absorbable synthetic mesh. The study populations included two groups: (A) 92 obese patients-reinforced hiatoplasty concurrent with bariatric procedure; (B) 28 non-obese patients-reinforced hiatoplasty concurrent with antireflux surgery. Read More

JSLS 2019 Jan-Mar;23(1)

Department of Surgery, San Angelo Community Medical Center, San Angelo, TX 76904, USA.

Background And Objectives: Transoral incisionless fundoplication is an alternative to traditional laparoscopic fundoplications. Recently, hiatal hernia repair combined with transoral incisionless fundoplication has become an accepted modification of the original procedure; however, outcomes information, particularly objective pH monitoring, has been sparse. We retrospectively review the subjective and objective outcomes of transoral incisionless fundoplication combined with hiatal hernia repair. Read More

JSLS 2019 Jan-Mar;23(1)

Chicago Institute of Minimally Invasive Surgery, Skokie, Illinois, USA.

Background: The main indications for revision of bariatric surgery are inadequate weight loss, weight regain, or complications. The objective of revision is to restore the restrictive component and/or add a malabsorptive component.

Objectives: To evaluate the effectiveness of revisional laparoscopic bariatric surgery for loss of weight and assess the risks and benefits associated with these technically demanding procedures. Read More

Surg Endosc 2019 Jan 22. Epub 2019 Jan 22.

Steinberg-Bernstein Centre for Minimally Invasive Surgery and Innovation, McGill University Health Centre, Montreal, QC, Canada.

Background: Operative skills correlate with patient outcomes, yet at the completion of training or after learning a new procedure, these skills are rarely formally evaluated. There is interest in the use of summative video assessment of laparoscopic benign foregut and hiatal surgery (LFS). If this is to be used to determine competency, it must meet the robust criteria established for high-stakes assessments. Read More

J Gastroenterol Hepatol 2019 Jan 22. Epub 2019 Jan 22.

Department of Internal Medicine, Saga Medical School, Saga, Japan.

Background And Aim: Barrett's esophagus and colorectal polyps have several overlapping risk factors. Whereas several reports in Western countries have indicated a close relationship between Barrett's esophagus and colorectal polyps, the relationship between these two diseases remains unclear in Japan. This study was performed to determine whether the prevalence of Barrett's esophagus is related to that of colorectal polyps in Japanese patients. Read More

Hernia 2019 Jan 19. Epub 2019 Jan 19.

Department of Surgery, EKHUFT, Ashford, Kent, UK.

Purpose: Repair of giant paraoesophageal herniae (GPEH) is technically challenging and requires significant experience in advanced foregut surgery. Controversy continues on suture versus mesh cruroplasty with the most recent systematic review and meta-analysis putting the onus on the operating surgeon. Study aim was to review whether the biological prosthesis (non-cross-linked bovine pericardium and porcine dermis) and the technique adopted for patients with GPEH had an influence on clinical and radiological recurrences. Read More

Acta Otolaryngol 2018 Nov 10;138(11):1004-1008. Epub 2019 Jan 10.

c Speech and Swallowing Centre, ENT , Hudiksvall Hospital , Hudiksvall , Sweden.

Background: Many physicians insist patients lose weight before their hiatal hernia (HH) condition and related symptoms including intermittent esophageal dysphagia (IED) and gastroesophageal reflux disease (GERD) can be treated, but it is not proven that body mass index (BMI) has an impact on exercise-based treatment of HH-related symptoms.

Aims/objectives: To investigate whether BMI has significance on IQoro® neuromuscular training (IQNT) effectiveness in treating HH-related symptoms.

Material And Methods: Eighty-six patients with sliding HH and enduring IED and GERD symptoms, despite proton pump inhibitor medication, were consecutively referred for 6 months' IQNT comprising 11/2 minutes daily. Read More

Obes Surg 2019 Jan 8. Epub 2019 Jan 8.

General Surgery Department, Endocrine Surgery Division, Clinic and University Hospital Valencia, Av. Blasco Ibañez 17, 46010, Valencia, Spain.

J Gastrointest Surg 2019 Jan 7. Epub 2019 Jan 7.

Center for Advanced Surgical Technology, University of Nebraska Medical Center, 986246 Nebraska Medical Center, Omaha, NE, 68198-6246, USA.

Background: The aim of this study is to identify factors that can predict hiatal hernia recurrence (HHR) in patients after anti-reflux surgery with hiatal hernia (HH) repair.

Methods: A single-institution, prospectively collected database was reviewed (January 2002-October 2015) with inclusion criteria of GERD and laparoscopic anti-reflux (AR) surgery with HH repair. Demographics, esophageal symptom scores, and pre- and post-upper gastrointestinal imaging (UGI) were collected. Read More

J Gastric Cancer 2018 Dec 27;18(4):313-327. Epub 2018 Dec 27.

Guideline Committee of Korean Anti-Reflux Surgery (KARS) Study Group.

The prevalence of gastroesophageal reflux disease (GERD) is increasing in Korea, and physicians, including surgeons, have been focusing on its treatment. Indeed, in Korea, medical treatment using a proton pump inhibitor is the mainstream treatment for GERD, while awareness of surgical treatment is limited. Accordingly, to promote the understanding of surgical treatment for GERD, the Korean Anti-Reflux Surgery Study Group published the Evidence-Based Practice Guideline for the Surgical Treatment of GERD. Read More

JSLS 2018 Oct-Dec;22(4)

Department of Surgery, Oklahoma State University, Comanche County Memorial Hospital, Lawton, Oklahoma, USA.

Background And Objectives: Biologic and resorbable synthetic materials are used commonly for crural repair reinforcement during laparoscopic hiatal herniorrhaphy. Recently, an ovine polymer-reinforced bioscaffold (OPRBS) has been developed for reinforcement of abdominal wall and hiatal herniorrhaphies. This is the first reported series on use of OPRBS in hiatal hernia repairs. Read More

Am Surg 2018 Dec;84(12):1945-1950

Gastroesophageal reflux disease, associated with sliding or large paraesophageal hiatal hernia, represents a common clinical presentation. The repair of large paraesophageal hiatal hernias is still a challenge in minimally invasive surgery. Between March 2014 and August 2016, 50 patients (18 males and 32 females) underwent robotic fundoplication (17 sliding and 33 paraesophageal hernias). Read More

Eur J Cardiothorac Surg 2018 Dec 27. Epub 2018 Dec 27.

Department of Thoracic Surgery, Disease of the Esophagus and Lung Transplantation, North Hospital, Aix-Marseille University, Marseille, France.

Objectives: Hiatal hernias (HH) after oesophagectomy are rare, and their surgical management is not well standardized. Our goal was to report on the management of HH after oesophagectomy in high-volume tertiary European French-speaking centres.

Methods: We conducted a retrospective multicentre study among 19 European French-speaking departments of upper gastrointestinal and/or thoracic surgery. Read More

Chirurgia (Bucur) 2018 Nov-Dec;113(6):849-856

Transoral Incisionless Fundoplication (TIF) with EsophyX device for a well selected GERD patient population has proven its efficacy, safety and durability. We present a case report of a male, 63 y old, with typical and atypical GERD symptoms started 15 years ago. The esophagogastroduodenoscopy (EGD) showed a Hiatal Hernia (HH) of 3 cm and an erosive esophagitis Los Angeles Grade B. Read More

Chirurgia (Bucur) 2018 Nov-Dec;113(6):765-771

Purpose/Aim: Paraesophageal hiatus hernias are seldom found, however the incidence is increasing accounting for 5-10% of all hiatal hernias. The aim of this review is to emphasize controversies in clinical presentation, essential workup investigations and highlight non-surgical and surgical management options. A PubMed literature search using the keywords "large or giant paraesophageal hernia", "hiatus or hiatal hernia", "laparoscopic surgery", "antireflux surgery", "mesh", "gastric volvulus" and "diaphragmatic hernia" published between 1998 until 2017 was conducted. Read More

Eur J Cardiothorac Surg 2018 Dec 18. Epub 2018 Dec 18.

Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, Netherlands.

J Laparoendosc Adv Surg Tech A 2019 Feb 15;29(2):198-202. Epub 2018 Dec 15.

1 Department of Surgery, Mayo Clinic in Florida , Jacksonville, Florida.

Introduction: Laparoscopic magnetic sphincter augmentation (MSA) has been shown to be efficacious therapy for gastroesophageal reflux disease (GERD) refractory to maximal medical management. Herein, we present our experience with this procedure and an analysis of our outcomes.

Materials And Methods: Medical records were retrospectively reviewed of 98 patients who underwent laparoscopic MSA for GERD at a single institution from 2012 to 2016. Read More

Surg Case Rep 2018 Dec 13;4(1):144. Epub 2018 Dec 13.

Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.

Background: Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia.

Case Presentation: An 81-year-old woman with chest discomfort was admitted to the hospital, where barium esophagography showed a sliding esophageal hiatal hernia and a tumor of the lower esophagus and gastric wall. Read More

Obes Surg 2019 Feb;29(2):744-746

Division of Foregut, Bariatric and Advanced GI Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, 11794, USA.

Obesity is associated with the development of gastroesophageal reflux disease (GERD) and hiatal hernia (HH). This study aimed to assess practice patterns regarding concomitant HH repair (HHR) during laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). The incidence of concomitant HHR with LSG or LRYGB was analyzed using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. Read More

Khirurgiia (Mosk) 2018 (10):18-22

South Regional Medicak Center of Federal Medical-Biological Agency of Russia, Rostov Clinical Hospital, Rostov-on-Don, Russia.

Aim: To assess an effectiveness of FAST TRACK rehabilitation in patients after laparoscopic repair of hiatal hernia.

Material And Methods: There were 87 patients with hiatal hernia who underwent laparoscopic Nissen-Rossetti procedure with wrapping only anterior wall of the stomach. FAST TRACK approach was applied in 49 patients, standard protocol - in 38 cases. Read More

Surg Technol Int 2018 Nov 30;34. Epub 2018 Nov 30.

University of Arizona Medical Center, Tucson, AZ.

Purpose: Nissen fundoplication is associated with poor long-term durability, as well as dysphasia and gas bloat. We report here the long-term results of modified Belsey fundoplication (Gastroesophageal Valvuloplasty; GEV) performed laparoscopically using a surgical robot.

Methods: Patients who underwent robotic GEV were reviewed retrospectively. Read More

Intern Emerg Med 2018 Nov 29. Epub 2018 Nov 29.

Digestive Endoscopy Unit, Humanitas Research Hospital, Milan, Italy.

Modern medicine provides almost infinite diagnostic and therapeutic possibilities if compared to the past. As a result, patients undergo a multiplication of tests and therapies, which in turn may trigger further tests, often based on physicians' attitudes or beliefs, which are not always evidence-based. The Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO) adhered to the Choosing Wisely Campaign to promote an informed, evidence-based approach to gastroenterological problems. Read More

Digestion 2019 27;99(2):185-190. Epub 2018 Nov 27.

Division of Gastroenterological Surgery, Tokai University, Oiso, Japan.

Background: The incidence of esophageal adenocarcinoma in Europe and the United States rapidly increased from the latter half of the 1970s and exceeded that of esophageal squamous cell carcinoma in the latter half of the 1990s, currently accounting for approximately 60% of all esophageal carcinomas. Recently, its incidence has also increased in Japan, raising concerns that it will follow a course similar to that in Europe and the United States.

Summary: The incidence of esophageal adenocarcinoma in Japan was about 2% until the 1990s, but in recent years, it has risen to 6. Read More

Surg Endosc 2018 Nov 26. Epub 2018 Nov 26.

Division of General Surgery, University of Kentucky, Lexington, KY, USA.

Background: Laparoscopic hiatal hernia repair via Toupet or Nissen fundoplication remains the most commonly performed procedures for management of large hiatal hernia. Few studies have compared the procedures' long-term effectiveness. This study sought to characterize the efficacy of laparoscopic Toupet versus Nissen fundoplication for types III and IV hiatal hernia. Read More

J Am Soc Echocardiogr 2018 Nov 22. Epub 2018 Nov 22.

Department of Cardiology, Concord Repatriation General Hospital, Sydney, Australia. Electronic address:

Background: Patients with large hiatal hernias (HH) frequently experience postprandial dyspnea. The aim of this study was to evaluate whether feeding induced cardiac compression in these patients using echocardiography.

Methods: Transthoracic echocardiography was performed during fasting and 30 min after feeding (300 g rice pudding) in patients with HHs (n = 32; mean age, 72 ± 9 years). Read More

PLoS Med 2018 Nov 20;15(11):e1002686. Epub 2018 Nov 20.

Department of Radiology, Stanford University, Stanford, California, United States of America.

Background: Chest radiograph interpretation is critical for the detection of thoracic diseases, including tuberculosis and lung cancer, which affect millions of people worldwide each year. This time-consuming task typically requires expert radiologists to read the images, leading to fatigue-based diagnostic error and lack of diagnostic expertise in areas of the world where radiologists are not available. Recently, deep learning approaches have been able to achieve expert-level performance in medical image interpretation tasks, powered by large network architectures and fueled by the emergence of large labeled datasets. Read More

Surg Endosc 2018 Nov 19. Epub 2018 Nov 19.

Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Norra Stationsgatan 67, Solna (L1:00), 171 76, Stockholm, Sweden.

Background: Individuals with Barrett's esophagus (BE) are at increased risk of high-grade dysplasia (HGD) and esophageal adenocarcinoma (EAC), but the cost-effectiveness of general surveillance of BE is low. This study aimed to identify a risk prediction model for tumor progression in individuals with BE based on age, sex, and risk factors found at upper endoscopy, enabling tailored surveillance.

Methods: This nested case-control study originated from a cohort of 8171 adults diagnosed with BE in 2006-2013 in the Swedish Patient Registry. Read More

Am Surg 2018 Jul;84(7):e251-e253

Eur Radiol 2018 Nov 12. Epub 2018 Nov 12.

Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Purpose: To evaluate the diagnostic performance of swallowing MRI of the gastroesophageal junction (GEJ) in the postoperative care of patients after laparoscopic antireflux surgery (LARS) MATERIAL AND METHODS: In this institutional review board-approved prospective study, 79 symptomatic patients (mean age, 52.3 years; range, 26-80 years) were evaluated after laparoscopic Nissen fundoplication. MRI findings were correlated with revision surgery, endoscopy, and high-resolution manometry (HRM) as standard of reference. Read More

Surg Endosc 2018 Nov 7. Epub 2018 Nov 7.

Department of Oesophago-Gastric Surgery, Royal Infirmary Edinburgh, 51 Little France Crescent, Old Dalkeith Road, Edinburgh, EH16 4SA, UK.

Introduction: There are limited data regarding long-term outcomes after surgical repair of giant paraoesophageal hiatus hernia (GPHH). The aim of this study was to assess symptomatic recurrence and patient-reported outcomes following GPHH repair.

Methods: 178 patients undergoing elective (127) and emergency (51) GPHH repair between 1994 and 2015 were identified from the prospectively collected Lothian Surgical Audit database. Read More

Dysphagia 2018 Nov 7. Epub 2018 Nov 7.

Department of Otolaryngology-Head & Neck Surgery, Center for Voice and Swallowing, University of California, Davis, 2521 Stockton Blvd., Suite 7200, Sacramento, CA, 95817, USA.

Although the precise etiology of cricopharyngeus muscle (CPM) dysfunction (CPMD) is uncertain, many have hypothesized that a hypertrophied CPM may develop as a protective compensation against gastroesophageal reflux disease (GERD). The purpose of this investigation was to evaluate the association between CPMD and the presence of hiatal hernia (HH) in an attempt to elucidate the potential etiology of CPMD. The charts of individuals who underwent video fluoroscopic esophagrams between 01/01/14 and 10/30/16 were reviewed from an electronic database. Read More

AJR Am J Roentgenol 2019 Jan 7;212(1):103-108. Epub 2018 Nov 7.

1 Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110.

Objective: The objective of this study was to identify CT findings and determine interobserver reliability of surgically proven gastric volvulus.

Materials And Methods: This single-center retrospective study included 30 patients (21 women, nine men; mean age, 73 years old) with surgically proven gastric volvulus who underwent preoperative CT and 31 age- and sex-matched control subjects (21 women, nine men; mean age, 74 years old) with large hiatal hernias who were imaged for reasons other than abdominal pain. Two blinded radiologists reviewed the CT images and recorded findings of organoaxial and mesenteroaxial gastric volvulus and ischemia. Read More

Obes Surg 2019 Feb;29(2):626-631

Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.

Background: Approximately 14% of Austria's 8.5 million inhabitants have a body mass index (BMI) > 30 kg/m. The laparoscopic adjustable gastric banding (LAGB) was introduced in Austria in 1994, where about 10. Read More

Surg Endosc 2018 Nov 1. Epub 2018 Nov 1.

Division of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of University Of Southern California, 1510 San Pablo St. Suite 510, Los Angeles, CA, 90033, USA.

Background: Recurrent or persistent symptoms of reflux, dysphagia, or device erosion can lead to removal of the magnetic sphincter augmentation (MSA aka Linx) device. Device removal has been previously reported, and outcomes of various surgical management strategies at the time of removal have not been well described.

Methods: This is a retrospective review of patients undergoing MSA removal from March 2009 to September 2017 in a single institution. Read More

J Natl Med Assoc 2018 Oct 23. Epub 2018 Oct 23.

Division of Gastroenterology, University of Florida/Jacksonville, Jacksonville, FL, USA; Division of Gastroenterology and Hepatology, Augusta University-Medical College of Georgia, Augusta, GA. Electronic address:

Background And Study Aims: Barrett's Esophagus (BE) is a well-recognized pre-malignant condition. Previous data indicate histologically confirmed BE frequency varies by ethnicity in the United States. However, clinical factor assessment to explain this has only occurred in a veteran population to date. Read More

Surg Endosc 2018 Oct 25. Epub 2018 Oct 25.

Division of GI/Minimally Invasive Surgery, Department of Surgery, Loyola University Chicago Stritch School of Medicine, 2160 South First Avenue, Maywood, IL, 60153, USA.

Background: Thoracic and foregut operations can cause vagal nerve injury resulting in delayed gastric emptying or gastroparesis. However, the cause of gastroparesis in these patients is not always from a vagal injury. We hypothesize that vagal nerve integrity (VNI) testing may better define who has vagal nerve dysfunction. Read More

Surg Endosc 2018 Oct 22. Epub 2018 Oct 22.

Department of Surgery, Meander Medical Center, P.O. box 1502, 3800 BM, Amersfoort, The Netherlands.

Introduction: Published data regarding robot-assisted hiatal hernia repair are mainly limited to small cohorts. This study aimed to provide information on the morbidity and mortality of robot-assisted complex hiatal hernia repair and redo anti-reflux surgery in a high-volume center.

Materials And Methods: All patients that underwent robot-assisted hiatal hernia repair, redo hiatal hernia repair, and anti-reflux surgery between 2011 and 2017 at the Meander Medical Centre, Amersfoort, the Netherlands were evaluated. Read More

Clin Gastroenterol Hepatol 2018 Oct 17. Epub 2018 Oct 17.

Division of Gastroenterology,Washington University School of Medicine, Saint Louis, Missouri. Electronic address:

Background & Aims: Dysphagia is a consequence of antireflux surgery (ARS) for gastroesophageal reflux disease (GERD). We studied patient management and symptomatic outcomes.

Methods: We performed a retrospective study of 157 consecutive adult patients with GERD (mean age, 65. Read More

Surg Endosc 2018 Oct 19. Epub 2018 Oct 19.

Department of Surgery C, Chaim Sheba Medical Center, Tel Hashomer, Israel.

Background: Failure or complications following laparoscopic adjustable gastric banding (LAGB) may necessitate band removal and conversional surgery. Band position and band-induced chronic vomiting create ideal conditions for de novo hiatal hernia (HH) formation. HH presence impedes and complicates conversional surgery by obscuring crucial anatomical landmarks and hindering precise gastric sleeve or pouch formation. Read More

Emerg Med J 2018 Nov;35(11):691

Emergency Department, Department of Emergency and Critical Care Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.

Clinical Introduction: A 69-year-old woman presented to the ED with a chief complaint of recurrent vomiting for 3 weeks. She was afebrile, blood pressure was 100/67 mm Hg, HR was 114/min, RR was 19/min and oxygen saturation was 98%. On physical examination, she had mild epigastric tenderness without guarding. Read More