Redo-Fundoplication with or without Intraoperative Endoscopy in Management of Failed Previous Anti-Reflux Surgery

Introduction: Gastroesophageal reflux disease (GERD) affects 10–20% of Western adults and significantlyreduces quality of life due to persistent symptoms. Nowadays laparoscopic fundoplication is the current goldstandard surgical treatment. Failures of primary fundoplication often result from anatomical issues like wrapmigration or dehiscence, requiring redo surgeries. Redo fundoplication is a complex procedure with higher risksand longer operative times. Despite variable outcomes, most patients report symptom relief and improved qualityof life, though complications still occur in a small percentage.Aim of work: Our study aims to evaluate the impact of intraoperative endoscopy on surgical outcomes in patientsundergoing redo fundoplication for failed anti-reflux surgeries, focusing on postoperative complications, symptomcontrol, and patient satisfaction.Patients and methods: This retrospective study included patients with failed primary fundoplication surgerieswho underwent redo procedures at the General Surgery Department, Ain Shams University Hospitals, from January2021, with a minimum follow-up period of 6 months. Patients were divided into two groups: Group A (withoutintraoperative endoscopy) and Group B (with intraoperative endoscopy). Outcomes were analyzed in terms ofintraoperative complications, postoperative symptom control, and patient satisfaction.Results: Group B demonstrated significantly fewer intraoperative complications compared to Group A.Six months postsurgery, patients in Group B reported lower incidences of dysphagia and regurgitation.Conclusion: So as a result intraoperative endoscopy may be considered as a valuable tool for improving outcomesin complex redo fundoplication surgeries.