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welcome back that was a great synopsis and summary of the surgical um minimally invasive side of treatment of the surgical site of the anti-reflux disease when we talk about surgeries we also always talk about redo surgeries in patients who need re-operations and thatamp;#39;s always a difficult topic because itamp;#39;s a difficult operation and for that we have a very experienced surgeon dr chris morse heamp;#39;s assistant professor at harvard medical school and a senior thoracic surgeon at mass general over to dr morse thank you for inviting me to speak iamp;#39;m going to talk about redo anti-reflux surgery and i thought iamp;#39;d start by showing a pretty common barium swallow of folks that present after anti-reflux surgery with what appears to be a slipped fund application causing docHub dysphagia weamp;#39;re going to go through a couple things today the patterns of failure the causes of failure the pre-operative evaluation of these patients and then look at the sur