Collis gastroplasty

Collis gastroplasty is a surgical procedure designed to lengthen the esophagus in patients suffering from severe gastroesophageal reflux disease (GERD) or in cases where the esophagus has been shortened due to other conditions such as Barrett's esophagus. This procedure is often performed when a standard fundoplication is not feasible due to the shortened esophagus. Collis gastroplasty is typically combined with a fundoplication procedure, most commonly a Nissen fundoplication, to prevent reflux.

Indications

Collis gastroplasty is indicated for patients with severe GERD who have a shortened esophagus as a result of chronic acid exposure. This condition can lead to complications such as Barrett's esophagus, a precancerous condition where the esophageal lining changes to resemble the lining of the intestine. The procedure is also indicated when previous reflux surgery has failed or when a hiatal hernia is present.

Procedure

The Collis gastroplasty procedure involves creating a controlled lengthening of the esophagus. This is achieved by making a vertical incision along the stomach near the esophagogastric junction, effectively creating a tubular extension of the esophagus from the stomach tissue. This extension is then wrapped around the lower esophagus in a fundoplication procedure to prevent acid reflux.

The procedure can be performed using either open surgery or minimally invasive techniques, such as laparoscopy. The choice of technique depends on the patient's specific condition, previous surgeries, and the surgeon's expertise.

Risks and Complications

As with any surgical procedure, Collis gastroplasty carries risks and potential complications. These may include:

• Dysphagia (difficulty swallowing)
• Recurrence of reflux symptoms
• Leakage at the site of the gastroplasty
• Infection
• Pneumonia
• Bleeding

Postoperative Care

Postoperative care involves a stay in the hospital to monitor the patient's recovery and manage pain. A diet of liquids is typically recommended initially, gradually progressing to soft foods as tolerated. Patients are advised to avoid strenuous activities and heavy lifting for a period of time after the surgery.

Outcomes

Collis gastroplasty, when combined with fundoplication, has been shown to be effective in managing GERD symptoms in patients with a shortened esophagus. It can improve quality of life and reduce the risk of esophageal cancer associated with Barrett's esophagus. However, long-term outcomes depend on various factors, including the patient's adherence to postoperative guidelines and lifestyle modifications.

See Also

• Gastroesophageal reflux disease
• Fundoplication
• Barrett's esophagus
• Hiatal hernia