Endoscopic gastroplasty is being promoted as a new minimally invasive procedure for the treatment of gastroesophageal reflux disease. In the case presented here, however, we encountered abdominal perforation as a severe complication of this procedure. Because immediate action was taken when the symptoms developed, and by maintaining close collaboration with the surgeons, it was possible to keep the treatment minimally invasive: the leakage was detected endoscopically and the defect was closed laparoscopically and covered by a fundoplication. This experience emphasises the importance of appropriate management of complications as part of the evaluation of new endoscopic methods.
References
1
Wienbeck M, Barnert J.
Epidemiology of reflux disease and reflux esophagitis.
Scand J Gastroenterol.
1989;
156 (Suppl)
7-13
2
Romagnuolo J, Meier M A, Sadowski D C.
Medical or surgical therapy for erosive reflux esophagitis: cost-utility analysis using a Markov model.
Ann Surg.
2002;
236
191-202
3
Mason R J, Filipi C J, DeMeester T R. et al .
A new intraluminal anti-gastroesophageal reflux procedure in baboons.
Gastrointest Endosc.
1997;
45
283-290
4
Kadirkamanathan S S, Evans D F, Gong F. et al .
Antireflux operations at flexible endoscopy using endoluminal stitching techniques: an experimental study.
Gastrointest Endosc.
1996;
44
133-143
5
Filipi C J, Lehman G A, Rothstein R I. et al .
Transoral flexible endoscopic suturing for treatment of GERD: a multicenter trial.
Gastrointest Endosc.
2001;
53
416-422
7
Koperna T, Schulz F.
Re-laparotomy in peritonitis: prognosis and treatment of patients with persisting intra-abdominal infection.
World J Surg.
2000;
24
32-37
8
Mahmood Z, McMahon B P, Arfin Q. et al .
Endocinch therapy for gastro-oesophageal reflux disease: a one-year prospective follow-up.
Gut.
2003;
52
34-39
