Gastroesophageal Reflux Disease

An interactive discussion about gastroesophageal reflux disease between Jeffrey Ponsky, MD and Michael Rosen, MD. Dr. Rosen is a professor of surgery at the Cleveland Clinic Lerner College of Medicine, and general surgery staff in department of surgery at Cleveland Clinic in Cleveland, OH. Dr. Ponsky, is a professor of surgery at the Cleveland Clinic Lerner College of Medicine and Department of Surgery at Cleveland Clinic. Table of Contents 00:01:06|GERD 00:01:16|Case presentation 40 year old woman with heartburn(00:01:16:30) 00:02:56|H2-blockers 00:03:19|Refractory symptoms after PPI 00:04:23|Role of EGD- assess esophagitis, and rule out Barrett’s 00:04:57|Frequency of EGD 00:06:17|Bravo-study performed with patient off PPI 00:07:13|Use of manometry done prior to operative intervention 00:07:41|Management after Bravo results 00:09:30|Workup for patient not responding to PPI management 00:11:04|What is manometry? 00:13:18|Surgical interventions to consider for GERD 00:13:54|Nissen Fundoplication 00:17:05|Nissen Technique 00:17:36|Crural closure 00:18:32|Manometry to tailor operation 00:19:38|Description of Toupet 00:21:09|Complications of anti-reflux surgery 00:22:31|Loose wrap 00:23:07|Management of rare case of long-term dysphagia-postoperative symptomatic dysphagia to solids 00:23:52|Management of rare case of long-term dysphagia- patient 1-year postoperative symptomatic dysphagia to solids 00:27:12|Management of patient with recurrent symptoms 00:29:37|Slipped Nissen surgically? 00:32:30|Injury to the anterior vagus nerve what do you do?