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Related Experiment Videos

Laparoscopic versus open fundoplication in infants.

S Somme1, J A Rodriguez, D G Kirsch

  • 1Division of Pediatric Surgery, Department of Surgery, Children's Hospital of New Orleans, LA, USA.

Surgical Endoscopy
|April 19, 2002
PubMed
Summary

Laparoscopic Nissen fundoplication (LNF) offers comparable outcomes to open Nissen fundoplication (ONF) for infants with severe gastroesophageal reflux disease (GERD). LNF demonstrates faster feeding resumption and lower recurrence rates, making it a viable alternative.

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Surgery

Background:

  • Gastroesophageal reflux disease (GERD) significantly impacts infant health.
  • Nissen fundoplication is a common surgical intervention for severe GERD.
  • The efficacy of laparoscopic Nissen fundoplication (LNF) in infants remains under investigation.

Purpose of the Study:

  • To compare the surgical outcomes of laparoscopic Nissen fundoplication (LNF) versus open Nissen fundoplication (ONF) in infants under one year of age with severe GERD.
  • To evaluate operative time, feeding resumption, complications, and recurrence rates between the two surgical approaches.

Main Methods:

  • A retrospective review of 55 consecutive Nissen fundoplications for GERD in infants (<1 year old) between 1996 and 2000.

Related Experiment Videos

  • Patients were divided into LNF (n=39) and ONF (n=14) groups.
  • Outcomes assessed included operative time, time to feeding initiation and completion, postoperative complications, and reflux recurrence.

    • Main Results:

    • LNF had a longer average operative time (120 min) compared to ONF (91 min) (p < 0.05).
    • Infants undergoing LNF resumed feeding significantly faster (1.3 days) than ONF patients (3 days) (p < 0.05).
    • Recurrent reflux was significantly lower in the LNF group (2.6%) compared to the ONF group (14.3%) (p < 0.05).

    Conclusions:

    • Laparoscopic Nissen fundoplication (LNF) provides comparable surgical outcomes to open Nissen fundoplication (ONF) in infants with severe GERD.
    • LNF spares infants the morbidity associated with celiotomy.
    • Resumption of nutritional regimens is equally efficient, and LNF shows a trend towards lower recurrence rates.