Laparoscopic Omega-type fundoplication (ΩTF) is a Safe and Effective Method for GERD - Data on Radiologic and Clinical Follow-Up.

BACKGROUND

Laparoscopic Ω-type fundoplication (ΩTF) is a novel technique for gastroesophageal reflux disease (GERD), combining hiatoplasty with His-angle reconstruction by a 150° two-layered left-sided fundoplication. This retrospective analysis evaluated safety and efficacy of ΩTF during one-year follow-up.

METHODS

198 consecutive patients undergoing ΩTF at the Medical University Vienna were included. Safety, symptoms, hernia recurrence, and quality of life were evaluated. GERD-HRQL scores and contrast swallow X-rays were performed during follow-up.

RESULTS

Early hernia recurrence occurred in 4 patients, 2 requiring revisional surgery. Normal food intake by day 2 was achieved in 98.6 %, median hospital stay was 1day (IQR: 1-2). At mean follow-up of 1.1 (0.7-1.5) years, PPI use decreased from 88.0% to 5.1%. Reflux, bloating and dysphagia decreased to 4.6%, 8.8% and 4.0% (p < 0.001), while new onset dysphagia occurred in 2.6%. GERD-HRQLs improved from 25 ± 9.6 to 4 ± 7.5 (Δ-17, p < 0.001). Suboptimal clinical response was reported by 4.5% (n = 9), whereas radiologic recurrence occurred in 6 cases (3.0%). Revisional surgery was required in 7 cases (3.5%). Overall, 82.4% reported improved postoperative satisfaction and QoL (p < 0.001).

CONCLUSION

ΩTF appears safe and effective, providing substantial symptom relief, improved QoL, and low short-term hernia recurrence. Prospective studies are required to confirm these results.