Replay of: Gastroesophageal Reflux Disease (GERD)
Live Webcast Shows Minimally Invasive Surgery to Correct Reflux
First Seen: Tuesday, May 4, 2004,
5:30 p.m. EDT (21:30 UTC)
BALTIMORE, MD — A live webcast originating from the "Operating
Room of the Future" at the University of Maryland Medical Center in
Baltimore showed minimally invasive surgery to treat a serious form
of heartburn, called gastroesophageal reflux disease (GERD). The webcast
began at 5:30 p.m. on Tuesday, May 4, 2004.
During the procedure, a laparoscopic Nissen fundoplication, surgeons
made five small incisions and used a laparoscope (a long, thin instrument
that contains a video camera) to repair the lower esophageal sphincter,
a muscle that separates the stomach and esophagus. Normally, that muscle
closes after a person eats or drinks to keep food and stomach acids
from returning up into the esophagus. But in people who experience chronic
reflux, the muscle does not stay closed tightly or is unable to close
properly, and they have heartburn, chest pain, cough, difficulty swallowing
or regurgitation. Left untreated, reflux can lead to serious complications,
including esophageal ulcers or bleeding.
"The beauty of this procedure is that we make the repair using the
patient's own anatomy," says Adrian E. Park, M.D., head of General Surgery
at the University of Maryland Medical Center and professor of surgery
at the University of Maryland School of Medicine.
"In this procedure, we wrap a part of the stomach known as the gastric
fundus around the lower esophagus, which prevents the flow of acid back
into the esophagus," adds Dr. Park, who will perform the surgery during
the live webcast.
J. Scott Roth, M.D., head of surgical endoscopy at the University
of Maryland Medical Center and a faculty member of the University of
Maryland School of Medicine, explained the progress of the operation
during the live webcast, and provided background information about the
Paul Castellanos, M.D., assistant professor of surgery at the University of Maryland School of Medicine and medical director of the Center for Voice, Swallowing and Esophageal Disorders at the University of Maryland Medical Center, will also be in the operating room during the webcast. Dr. Castellanos is an otolaryngologist who works closely with Dr. Park. He practices the subspecialty of laryngology along with head and neck surgery. He has coined the term "Laryngopharyngeal Extra-esophageal Reflux Disease," or LERD, as an entity related to GERD but often the source of puzzlement to clinicians because these patients have reflux related throat disease without commonly having heartburn. They do not often have abnormalities of the lower esophagus such as erosions, ulcerations, strictures or Barrett's esophagus, a premalignant condition related to GERD.
"Patients with LERD are often misdiagnosed and can have their condition progress to permanent voice loss, airway strictures, lung disease and even head and neck cancer," explains Dr. Castellanos.
The webcast uses Realplayer
to display both video and synchronized slides in side by side windows.
Viewers can download
a free copy of the player here.
It is not necessary to purchase any of Real's premium players or subscription
plans. The free basic player is all that is required to view the surgery.