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July 1973

Transthoracic or Transabdominal Fundoplication

Arch Surg. 1973;107(1):112. doi:10.1001/archsurg.1973.01350190094027

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To the Editor.—In their excellent article in the February issue of the Archives (106:164, 1973) entitled "Postoperative Diaphragmatic Herniation Following Transthoracic Fundoplication," Drs. Balison, Macgregor, and Woodward describe the importance of the complications. They stress the necessity for adequate closure of the incision in the diaphragm to prevent complications. They mention also the necessity for an adequate diaphragmatic incision to prevent "unrecognized splenic or vascular injury." Nowhere in this article was there mentioned the possibility of accomplishing this same procedure through the abdomen, thus completely doing away with the necessity for diaphragmatic incision. I believe that many other surgeons besides myself have accomplished this operation transabdominally. Shouldn't the possibility of transabdominal fundoplication be mentioned, if not stressed?

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