Is it in your opinion good practice to follow-up a Nissen fundoplication by an endoscopy at the three-month or six-month mark? Additionally, is there any serious risk in damaging the wrap? Is any sedation necessary in order to prevent a strong gag reflex?
No risk even after 3 months if the patient is fasting overnight and sedated with propofol.
En este punto, lo más importante es revisar muy bien la indicación del estudio endoscópico. Si dicho estudio es realmente necesario, no habrá problema de realizarlo. Recordar que existen además endoscopios de diferentes diámetros. Sumariamente, la pregunta es qué escenarios me harían indicar el estudio endoscópico.
A high proprtion of patients end up having ensoscopy after HH repair. A standard 8-12mm endoscope will not damage the repair. Even a dilatation to 20mm whilst giving a gentle stretch is unlikely to disrupt a wrap which should be loose, short and floppy anyway.
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