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Tailoring the wrap: intraoperative functional lumen imaging probe (FLIP) during hiatal hernia repair.
- Source :
- Surgical Endoscopy & Other Interventional Techniques; Jun2024, Vol. 38 Issue 6, p3425-3432, 8p
- Publication Year :
- 2024
-
Abstract
- Introduction: The introduction of the functional lumen imaging probe (FLIP) has provided objective, real-time feedback on the geometric variations with each component of a hiatal hernia repair (HHR). The utility of this technology in altering intraoperative decision-making has been scarcely reported. Herein, we report a single-center series of intraoperative FLIP during HHR. Methods: A retrospective review of electronic medical records between 2020 and 2022 was conducted and all patients undergoing non-recurrent HHR with FLIP were queried. Patient and hernia characteristics, intraoperative FLIP values and changes in decision-making, as well as early post-operative outcomes were reported. Both diameter and distensibility index (DI) were measured at 40 ml and 50 ml balloon inflation after hiatal dissection, after hiatal closure, and after fundoplication when indicated. Results: Thirty-three patients met inclusion criteria. Mean age was 62 ± 14 years and mean BMI was 28 ± 6 kg/m<superscript>2</superscript>. The majority (53%) were type I hiatal hernias. The largest drop in DI occurred after hiatal closure, with minimal change seen after fundoplication (mean DI of 4.3 ± 2. after completion of HH dissection, vs 2.7 ± 1.2 after hiatal closure and 2.3 ± 1 after fundoplication when performed). In 13 (39%) of cases, FLIP values directly impacted intraoperative decision-making. Fundoplication was deferred in 4/13 (31%) patients, the wrap was loosened in 2/13 (15%); the type of fundoplication was altered to achieve adequate anti-reflux values in 2/13 (15%) patients, and in 1/13 (3%) the wrap was tightened. Conclusion: FLIP measurements can be used intraoperatively to guide decision-making and alter management plan based on objective values. Long-term outcomes and further prospective studies are required to better delineate the value of this technology. [ABSTRACT FROM AUTHOR]
- Subjects :
- ABDOMINAL physiology
HERNIA surgery
MEDICAL technology
SURGERY
PATIENTS
DECISION making in clinical medicine
SURGICAL therapeutics
RETROSPECTIVE studies
TREATMENT effectiveness
PREOPERATIVE care
DESCRIPTIVE statistics
INTRAOPERATIVE monitoring
DIGESTIVE organ surgery
SURGICAL complications
ELECTRONIC health records
MEDICAL records
ACQUISITION of data
FUNDOPLICATION
ABDOMINAL radiography
Subjects
Details
- Language :
- English
- ISSN :
- 18666817
- Volume :
- 38
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Surgical Endoscopy & Other Interventional Techniques
- Publication Type :
- Academic Journal
- Accession number :
- 177510111
- Full Text :
- https://doi.org/10.1007/s00464-024-10851-6