Laparoscopic Toupet's fundoplication in children

• Published in: Seminars in laparoscopic surgery Vol. 9; no. 3; pp. 163 - 167
• Main Author: Montupet, Philippe
• Format: Journal Article
• Language: English
• Published: United States 01-09-2002
• Subjects: Child; Fundoplication - adverse effects; Fundoplication - methods; Gastroesophageal Reflux - surgery; Humans; Laparoscopy; Pneumoperitoneum, Artificial; Reoperation; Treatment Outcome
• ISSN: 1071-5517

Laparoscopic fundoplication is performed commonly in children, and it represents "the gold standard" in children with gastroesophageal reflux disease (GERD) refractory to medical therapy. We present a single surgeon's experience with a posterior partial valve. Between May 1993 and May 2002, we operated on 574 children using Toupet's procedure. Among the patients, 24 were younger than 1 year of age, and 17 others were neurologically impaired. The average duration of the surgery was 1 hour. Complications were limited to 3 eviscerations of omentum through the port wounds. Relapse of GERD secondary to valve failure occurred in 6 patients, 1 neurologically impaired and 1 with mucoviscidosis. All six patients have been reoperated on laparoscopically, and Toupet fundoplication was performed again with good results. We think that the 270-degree posterior valve, according to Toupet, is a good procedure to adopt in children with GERD with a low rate of recurrence at long-term follow-up.