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Featured statements
▶Ep 9 · 15:39
uh, our, uh, study, uh, revealed that there is no difference, uh, or, uh, no importance of fixation of the esophagus to the pleura. Uh, like the most recent literature regarding this topic. So, uh, usually, and after this, after this study, we don't use or, or, uh, we don't take structures between the esophagus and the crust.
All of us know that missing from duplication is the most commonly adopted procedure all over the world. However, the post-operative procedure and the bloating frequently encountered raises the necessity for a more facic design.
BOB in Ped Surg 2023 - PAPSA Winner - Mohamad Mahmoud Qinawy, MD
▶Ep 9 · 5:02
clinicalNissen fundoplication is the most commonly adopted procedure for GERD all over the world↗
▶Ep 9 · 5:02
quoteAll of us know that this fundation is the most commonly adopted procedure all over the world. However, the post-operative phia and the bloating frequently encountered creates the necessity for a more facilitative design.↗
▶Ep 9 · 5:50
clinicalPost-operative dysphagia and bloating are frequently encountered after Nissen fundoplication, creating the necessity for a more facilitative design↗
▶Ep 9 · 6:20
quoteThe current GERD represents a significant clinical problem. It has been reported, reported to occur in up to 15% of children requiring re-operation.↗
▶Ep 9 · 6:20
epidemiologicalRecurrent GERD has been reported to occur in up to 15% of children requiring re-operation↗
▶Ep 9 · 6:40
clinicalThe study was a prospective single-blinded randomized comparative study conducted from October 2018 to February 2020 including 40 patients divided into two groups↗
▶Ep 9 · 7:10
clinicalThe operative setup is similar between Nissen fundoplication and Hill-Snow procedure↗
▶Ep 9 · 7:30
clinicalIn the Hill-Snow procedure, the first step after crural approximation is excision of the distal abdominal esophagus to the phrenic decision↗
▶Ep 9 · 8:20
clinicalThe Hill-Snow procedure establishes an angle of His by suturing the fundus of the stomach to the distal third of the esophagus with running 2-0 suture↗
▶Ep 9 · 10:00
clinicalStudy inclusion criteria included patients with GERD with failure of medical treatment, symptomatic hiatus hernia, patients presenting with obstruction, and patients with life-threatening symptoms like apnea↗
▶Ep 9 · 10:40
clinicalStudy excluded recurrent cases and giant hiatus hernia↗
▶Ep 9 · 11:00
clinicalOperative time was significantly longer in the Hill-Snow group when compared to the Nissen group↗
▶Ep 9 · 11:20
clinicalEarly postoperative bloating was found to be lower in the Hill-Snow group: 3 cases versus 15 cases in the Nissen group↗
▶Ep 9 · 11:40
clinicalEarly postoperative dysphagia was found to be lower in the Hill-Snow group: 2 cases versus 7 cases in the Nissen group↗
▶Ep 9 · 12:00
clinicalEarly vomiting was encountered more in the Hill-Snow group: 6 cases versus 2 cases in the Nissen group↗
▶Ep 9 · 12:20
clinicalThe incidence of dysphagia was found to be insignificant in both groups regarding late postoperative assessment, but it was of shorter duration in the Hill-Snow group↗
▶Ep 9 · 12:40
clinicalNo bloating was found in any Hill-Snow patient at late follow-up, while 11 cases from the Nissen group suffered from bloating↗
▶Ep 9 · 12:55
clinicalRecurrent vomiting and need for drugs was found in 8 cases in the Hill-Snow group versus 6 cases in the Nissen group↗
▶Ep 9 · 12:55
quoteTo conclude, there is no procedure offers an effective alternative to nasal ligation with no bloating and much less prophia, and so early return to the normal eating pattern.↗
▶Ep 9 · 13:05
clinicalThere were 3 recurrent Hill-Snow cases versus 2 recurrent Nissen cases↗
▶Ep 9 · 14:11
clinicalThe recurrent cases of Hill-Snow were found in the first 10 cases, which was attributed to the learning curve↗
▶Ep 9 · 15:39
clinicalRecent literature shows there is no importance of fixation of the esophagus to the crus, and current practice after this study does not use sutures between the esophagus and the crus↗
▶Ep 9 · 15:39
quoteuh, our, uh, study, uh, revealed that there is no difference, uh, or, uh, no importance of fixation of the esophagus to the pleura. Uh, like the most recent literature regarding this topic. So, uh, usually, and after this, after this study, we don't use or, or, uh, we don't take structures between the esophagus and the crust.↗
BOB Ped Surg 2023 - Mohamad Qinawy, PAPSA - Presentation
▶Ep 10 · 0:10
clinicalThe study was a prospective single-blinded randomized comparative study conducted from October 2018 to April 2020 including 40 patients divided into two groups↗
▶Ep 10 · 0:10
clinicalNissen fundoplication is the most commonly adopted procedure for GERD all over the world↗
▶Ep 10 · 0:10
clinicalPost-operative bloating is frequently encountered after Nissen fundoplication, raising the necessity for a more physiologic design↗
▶Ep 10 · 0:10
epidemiologicalRecurrent GERD has been reported to occur in up to 15% of children requiring re-operation↗
▶Ep 10 · 1:00
quoteAll of us know that missing from duplication is the most commonly adopted procedure all over the world. However, the post-operative procedure and the bloating frequently encountered raises the necessity for a more facic design.↗
▶Ep 10 · 1:30
quoteThe current GERD represents a significant clinical problem. It has been reported, reported to occur in up to 15% of children requiring re-operation.↗
▶Ep 10 · 2:00
clinicalThe first step of Helio procedure is fixation of the distal abdominal esophagus to the crura with non-absorbable sutures (1 or 2 sutures) to maintain the abdominal esophagus inside the abdomen↗
▶Ep 10 · 2:00
clinicalThe angle of His is established by suturing the fundus of the stomach to the length of the esophagus with running absorbable suture (Vicryl or silk)↗
▶Ep 10 · 2:00
clinicalThe last suture in Helio procedure incorporates the stomach, the phrenic ligament, the crura, and the proximal part of the abdominal esophagus↗
▶Ep 10 · 5:10
clinicalExclusion criteria included recurrent cases, giant paraesophageal hernia, and gastroparesis↗
▶Ep 10 · 5:10
clinicalInclusion criteria included patients with GERD with failure of medical treatment, symptomatic hiatus hernia, esophageal stricture, and life-threatening symptoms like apnea↗
▶Ep 10 · 5:10
clinicalOperative time was significantly longer in the Helio group when compared to the Nissen group↗
▶Ep 10 · 6:10
clinicalEarly dysphagia was found to be lower in the Helio group: 2 cases versus 7 cases in Nissen↗
▶Ep 10 · 6:10
clinicalEarly vomiting was encountered more in the Nissen group: 6 cases versus 2 cases in Helio↗
▶Ep 10 · 6:10
clinicalTime to start oral feeding was insignificant between both groups but was shorter duration in the Helio group↗
▶Ep 10 · 6:10
clinicalLate post-operative assessment found no bloating in any Helio patient while 11 cases from Nissen group suffered from bloating↗
▶Ep 10 · 6:10
clinicalRecurrent vomiting and need for drugs was found in 8 Nissen cases versus 6 Helio cases↗
▶Ep 10 · 6:10
opinionThe recurrent Helio cases were found in the first 10 cases, which was attributed to the learning curve↗
▶Ep 10 · 6:10
clinicalEarly post-operative bloating was found to be lower in the Helio group: 3 cases versus 15 cases in Nissen↗
▶Ep 10 · 6:10
clinicalThere were 3 recurrent Helio cases versus 2 Nissen cases↗
▶Ep 10 · 7:20
opinionHelio procedure offers an effective alternative to Nissen fundoplication with no bloating and much less dysphagia, and earlier return to normal eating pattern↗
▶Ep 10 · 7:20
quoteTo conclude, there is no procedure offers an effective alternative to less from theation with no bloating and much less dysphagia, and so early return to the normal eating pattern.↗
