Abstract
It is essential to get a proper knowledge about the anatomy and the physiology of the gastroesophageal junction and esophageal hiatus, in order to perform successful antireflux surgery. Anatomical antireflux barrier is composed of lower esophageal sphincter (LES) as an internal sphincter, crural diaphragm as an external sphincter, and a flap valve configuration between the LES and the gastric fundus. An important physiologic component of antireflux barrier is the maintained pressure gradient across the gastroesophageal junction. In GERD patients, these anatomical and physiological components in antireflux barrier are deranged. The goal of antireflux surgery is to restore these derangements by cruroplasty and partial or total fundoplication. Cruroplasty and the wrap constructed by gastric fundus should not be too tight nor too loose. Antireflux surgery also decreases transient LES relaxation (TLESR) by decreasing absolute number, and the proportion of TLESRs that are accompanied by reflux.
| Original language | English |
|---|---|
| Title of host publication | Laparoscopic Antireflux Surgery |
| Publisher | Springer Singapore |
| Pages | 7-13 |
| Number of pages | 7 |
| ISBN (Electronic) | 9789811971730 |
| ISBN (Print) | 9789811971723 |
| DOIs | |
| State | Published - 1 Jan 2023 |
Bibliographical note
Publisher Copyright:© The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2023.
Keywords
- Antireflux surgery
- Crural diaphragm
- Lower esophageal sphincter
- Transient lower esophageal sphincter relaxation