Esophagogastroduodenoscopy (EGD) with Placement of a Bravo Probe for pH and GERD Symptom Monitoring
Charu Paranjape, MD, FACS
Newton-Wellesley Hospital
Accurate diagnosis and monitoring of GERD are crucial for appropriate patient management and treatment selection. This demonstration highlights the advantages of the Bravo wireless system over traditional catheter-based methods for pH monitoring. The procedure proves particularly valuable in post-bariatric surgery patients, as illustrated in this case of a patient with previous sleeve gastrectomy, where GERD symptoms frequently require thorough evaluation. The extended 96-hour monitoring period provides comprehensive data regarding reflux patterns and symptom correlation, facilitating evidence-based decisions about medical or surgical management.
Robotic-Assisted Laparoscopic Paraesophageal Hiatal Hernia Repair with Fundoplication and Esophagogastroduodenoscopy
Hannah A. Bougleux Gomes, MD¹; Divyansh Agarwal, MD, PhD¹; Charu Paranjape¹’²
¹Massachusetts General Hospital/Brigham and Women’s Hospital
²Newton-Wellesley Hospital
A hiatal hernia occurs when part of an intra-abdominal organ, most commonly the stomach, migrates through the diaphragmatic crura. The condition can cause a range of uncomfortable symptoms, including heartburn, chest pain, and difficulty swallowing. While several individuals with a hiatal hernia can manage their symptoms with lifestyle changes and anti-reflux medications, some with refractory symptoms or complications secondary to the hernia require surgical treatment to repair the defect.
Here we present the case of a 60-year-old female with a paraoesophageal hiatal hernia and chronic gastrointestinal reflux disease (GERD) refractory to proton-pump inhibitors (PPI), dietary changes, and lifestyle modifications. She underwent an elective robotic hiatal hernia repair, fundoplication, and esophagogastroduodenoscopy (EGD) as a two-hour procedure with routine postprocedure recovery. This article and the associated video describe the pertinent history, evaluation, and operative steps of the procedure.
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