Functional pathologies affecting the digestive system represent a head, within
the field of paediatric pathologic surgery, in which laparoscopic surgery
has become today an indication of choice. Among such diseases, the pathology
affecting the esophagogastric junction is the one which, in percentage terms,
is most frequently faced by surgeons operating with mini-invasive techniques
(19). It has by now been established that the laparoscopic approach allows
the visualisation of every abdominal space, including the most secluded, such
as the inferior mediastinal area, where the cardioesophageal junction is located,
in a much clearer manner compared to traditional surgery. (5). In patients
affected by the gastroesophageal reflux disease (GERD), when medical treatment
fails or, anyhow, in the cases in which surgical treatment is indicated, traditional
surgery has proved to be effective also as far as long-term results are concerned
(3, 18). Nevertheless, traditional surgery involves a great number of complications,
both general and local, which restrict its application to very specific cases,
whilst frequently excluding encephalopathic children, who continue to represent
today a great share of the patients requiring surgical treatment (6,13). Thanks
to its known mini-invasiveness features, laparoscopic surgery makes antireflux
operations more acceptable, not only for the patients themselves, but also
for paediatrician-gastroenterologists, and this explains why, in compliance
with adequate indications, the number of antireflux surgical operations has
increased over the last years.
