Gastro-esophageal reflux disease (GERD) is caused by an impaired anatomic junction between the esophagus and the stomach. Typically, the acid gastric juice provokes a burning feeling. Anti-acid drugs represent the first line of GERD treatment. In case of failure, reconstructive anti-reflux surgery is advised (Nissen fundoplication procedure). Pre-operative work-up consists of a gastroscopy with biopsies if required, esophageal manometry, 24 hours-pH measures and also an esophago-gastro-duodenal barium meal X-ray. Surgical procedure is performed using robotic laparoscopic technology.
Malignant gastric cancer is diagnosed during gastroscopy with multiple biopsies, and it allows to locate the tumour in the stomach. Pre-operative work-up consists of endo-gastric ultrasound to evaluate the invasion of the gastric by the tumour and the size of gastric lymph nodes; abdominal CT-scan is performed to assess local or distant metastatic lesions. In cases of advanced gastric cancer, chemotherapy is advised before surgical resection. Depending on tumour histologic type and location, surgical resection consists of total or partial gastrectomy.
Robotic Nissen fundoplication redo for recurrent gastro-esophageal reflux disease
Robotic Nissen fundoplication for gastro-esophageal reflux disease
Total gastrectomy with Roux en Y loop