General Surgery

Gastroesopheal Reflux Disease

December 08, 2016
An interactive discussion about gastroesophageal reflux disease between Jeffrey Ponsky, MD and Michael Rosen, MD.

Dr. Rosen is a professor of surgery at the Cleveland Clinic Lerner College of Medicine, and general surgery staff in department of surgery at Cleveland Clinic in Cleveland, OH. Dr. Ponsky, is a professor of surgery at the Cleveland Clinic Lerner College of Medicine and Department of Surgery at Cleveland Clinic.


Sections

  • Play From Beginning / Intro (00:00)
  • Case presentation 40 year old woman with heartburn (01:16)
  • H2 Blockers (02:56)
  • Refractory symptoms after PPI (03:19)
  • Role of EGD- assess esophagitis, and rule out Barrett’s (04:23)
  • Frequency of EGD (04:57)
  • Bravo-study performed with patient off PPI (06:17)
  • Use of manometry done prior to operative intervention (07:13)
  • Management after Bravo results (07:41)
  • Workup for patient not responding to PPI management (09:30)
  • What is manometry? (11:04)
  • Surgical interventions to consider for GERD (13:18)
  • Nissen Fundoplication (13:54)
  • Nissen Technique (17:05)
  • Crural closure (17:36)
  • Manometry to tailor operation (18:32)
  • Description of Toupet (19:38)
  • Complications of anti-reflux surgery (21:09)
  • Loose wrap (22:31)
  • Management of rare case of long-term dysphagia-postoperative symptomatic dysphagia to solids (23:07)
  • Management of rare case of long-term dysphagia- patient 1-year postoperative symptomatic dysphagia to solids (23:52)
  • Management of patient with recurrent symptoms (27:12)
  • How to manage a Slipped Nissen surgically? (29:37)
  • Injury to the anterior vagus nerve what do you do? (32:30)

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