Abstract
OUTCOMES OF ADVANCED LAPAROSCOPIC UPPER GI SURGERY AT INITIAL PHASE OF ESTABLISHMENT AT A TERTIARY REFERRAL CENTRE IN NEPAL

Sujan Gautam*, Kunal Bikram Deo, Laligen Awale, Narendra Pandit and Shailesh Adhikary

ABSTRACT

Introduction: Advanced Laparoscopic upper GI surgery is underutilized among surgeons due o the steep learning curve despite the proven advantages. The study is done to access the feasibility and safety of advanced laparoscopic upper GI surgery in a learning period in a resource limited setting. Method: The prospectively maintained database of laparoscopic upper GI surgery between. January 2018 to July 2022 in the Department of Surgery of this institute was evaluated. Clinico- demographic parameters, diagnosis, surgeries, and their outcome were evaluated. Result: A total of 10 cases (male: female: 1:1) were performed. Laparoscopic procedure included Heller’s myotomy with Dor’s fundoplication (n=6), Nissen’s fundoplication (n=1), Hiatoplasty with Toupet fundoplication (n=1), en-masse ligation of para-aortic tissue (n=1) and esophageal mobilization and gastric pull up (n=1). Post operative complications were neuralgic pain at trocar site (n=1) and subcutaneous emphysema with acidosis (n=1).There was no operative 90 day mortality of advanced laparoscopic upper GI Surgery. Conclusion: Laparoscopic upper GI Surgery is safe, effective and feasible with acceptable postoperative outcome even in early learning curve setting in a resource limited set-up. Adoption of well standardized techniques with adequate training helps in achieving better outcome.

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