Key result
Cardiac tamponade during peri-hiatal surgery carries ~33% mortality, primarily driven by helical tack fixation.
Why the study?
Laparoscopic Nissen fundoplication is associated with a low incidence of severe peri-operative complications, but rare cardiovascular complications like cardiac tamponade have been reported.
Heightened vigilance for tamponade is warranted with helical tacks in laparoscopic peri-hiatal surgery; Level 5 data leave optimal fixation techniques open.
Laparoscopic Nissen fundoplication is becoming a popular technique in the surgical management of reflux disease. The advantages of laparoscopic surgery include shorter hospital stays, greater patient acceptance and decreased overall morbidity. Laparoscopic surgery eliminates the necessity for an upper abdominal incision and the consequent post-operative impairment of pulmonary mechanics. Laparoscopic Nissen fundoplication has been associated with a low incidence of severe peri-operative complications although of a different nature to those following the open procedure. We are reporting a rare case of acute cardiovascular collapse secondary to cardiac tamponade during laparoscopic Nissen fundoplication.
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Farlo et al. (1998) conducted a review in Iatrogenic cardiac tamponade following peri-hiatal surgery (n=30). Peri-hiatal surgery and graft fixation was evaluated on Overall mortality.
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