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Minimally Invasive Surgery
Volume 2014, Article ID 409727, 4 pages
http://dx.doi.org/10.1155/2014/409727
Clinical Study

Laparoscopic Watson Fundoplication Is Effective and Durable in Children with Gastrooesophageal Reflux

Department of Paediatric Surgery, Royal Alexandra Children’s Hospital, Brighton BN2 5BE, UK

Received 16 August 2014; Revised 7 December 2014; Accepted 15 December 2014; Published 31 December 2014

Academic Editor: Peng Hui Wang

Copyright © 2014 Matthew G. Dunckley et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gastroesophageal reflux (GOR) affects 2–8% of children over 3 years of age and is associated with significant morbidity. The disorder is particularly critical in neurologically impaired children, who have a high risk of aspiration. Traditionally, the surgical antireflux procedure of choice has been Nissen’s operation. However, this technique has a significant incidence of mechanical complications and has a reoperation rate of approximately 7%, leading to the development of alternative approaches. Watson’s technique of partial anterior fundoplication has been shown to achieve long-lasting reflux control in adults with few mechanical complications, but there is limited data in the paediatric population. We present here short- and long-term outcomes of laparoscopic Watson fundoplication in a series of 76 children and infants, 34% of whom had a degree of neurological impairment including severe cerebral palsy and hypoxic brain injury. The overall complication rate was 27.6%, of which only 1 was classified as major. To date, we have not recorded any incidences of perforation and no revisions. In our experience, Watson’s laparoscopic partial fundoplication can be performed with minimal complications and with durable results, not least in neurologically compromised children, making it a viable alternative to the Nissen procedure in paediatric surgery.