What is Collis gastroplasty? – Procedure, Complications, Recovery

What is Collis Gastroplasty? 

The procedure named ‘Collis gastroplasty’ is a way of treating the shortened esophagus resulting from gastroesophageal reflux disease. The stomach acid that travels back into the esophagus in gastroesophageal reflux disease (GERD) results in scarring, tissue changes, and inflammation which can sometimes cause the esophagus to shrink. This lengthening can avoid GERD complications and reduce the risk of future procedures related to reflux.

The Collis gastroplasty was first published in 1957 as a new treatment for patients with hiatal hernias and shorter esophagus to address issues about axial stress leading to hernia recurrence. This technique has undergone additional development as a direct result of the encouraging early results obtained in terms of both its safety and its effectiveness.

 As laparoscopic techniques for hiatal hernia repair became more common, the goal to avoid thoracic cavity violation and move toward a transabdominal approach to the treatment gained popularity.

What is Collis gastroplasty - Procedure, Complications, Recovery

Collis Gastroplasty Procedure

The fundamental cause of the patient’s illness can be treated with Collis gastroplasty, a minimally invasive treatment to lengthen a shortened esophagus. Collis gastroplasty is a crucial part of laparoscopic giant paraesophageal hernia (GPEH) treatment in patients who exhibit persistent esophageal shortening despite extensive laparoscopic mobilization. The surgeons are known for being experts in new ways of doing surgery, and they often perform both laparoscopic Nissen fundoplication and Collis gastroplasty during the same operation. The procedure is started by giving general anesthesia to the patient so that he/she does not feel any pain throughout the surgery. The other steps are:

  • After that five incisions of 2 centimeters are being made above the belly button.
  • The abdomen is then filled with carbon dioxide gas, which facilitates the movement of surgical instruments and provides an unobstructed view of the surgical region.
  • Doctors perform the procedure using a video camera and specialized devices and can gain access to the esophagus through the incisions made in the abdomen.
  • The fundus, or upper part of the stomach, is then used to create a tube that is then used to lengthen the esophagus.
  • The rest of the fundus tissue is then attached to the intestines.

Collis Gastroplasty Complications

Collis gastroplasty complications mostly include:

  • Bleeding at the site of surgery.
  • Abdomen-related infection (peritonitis).
  • Lower esophageal sphincter support is often lost when the wrapped section of the stomach unintentionally slips.
  • Unintentional ripping or perforation of the esophageal lining.

Collis Gastroplasty Recovery

Before initiating a diet, it is expedient to undergo an esophagram or upper gastrointestinal series to ensure that there is no leak. Although immediate recovery after a Collis gastroplasty does not differ significantly from typical post-fundoplication management in terms of diet progression or hospital stay, it is prudent to ensure that there is no leak through an esophagram or upper GI series. Despite the possibility of a leak, some surgeons may opt to keep an NG tube or an intra-abdominal drain in place after a Collis procedure. 

Over the long run, it is essential to be aware of the fact that the aperistaltic segment of the Collis that is within the wrap carries the potential to produce potential problems in the form of dysphagia or other functional limits. 

Patients are at risk of prolonged acid exposure in the distal esophagus if the fundoplication lies inferior to the top cuff of the Collis segment generated after the procedure. Patients with previous cases of Barrett’s esophagus are especially vulnerable to this and may require long-term use of acid-suppression drugs. Furthermore, patients with a Collis segment are at a higher risk of dysphagia or food or pill impaction within their aperistaltic segment. Counseling patients about these dangers before surgery is essential.

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