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Related Experiment Videos

Laparoscopic vs open approach for Nissen fundoplication. A comparative study.

E Chrysos1, J Tsiaoussis, E Athanasakis

  • 1Department of General Surgery, Gastrointestinal Surgery Unit, University Hospital of Heraklion, GR-Heraklion, Crete, Greece.

Surgical Endoscopy
|May 2, 2002
PubMed
Summary

Laparoscopic and open Nissen fundoplication are equally effective for gastroesophageal reflux disease (GERD). However, the open approach leads to more wound and respiratory complications, plus early post-meal fullness and bloating.

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Comparative Effectiveness Research

Background:

  • Gastroesophageal reflux disease (GERD) management often involves Nissen fundoplication.
  • Previous studies suggest similar outcomes for laparoscopic and open surgical approaches.
  • Nonrandomized trials form the basis of much of the existing evidence.

Purpose of the Study:

  • To compare the efficacy and safety of laparoscopic versus open Nissen fundoplication.
  • To evaluate functional outcomes and complication rates between the two surgical techniques.
  • To provide evidence-based guidance for GERD surgical treatment.

Main Methods:

  • A randomized controlled trial involving 106 patients with documented GERD.
  • Patients were assigned to either laparoscopic or open Nissen fundoplication.

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  • Preoperative and postoperative assessments included clinical evaluation, esophagogram, endoscopy, manometry, and pH monitoring.

    • Main Results:

    • Both surgical methods effectively controlled GERD symptoms and improved esophageal peristalsis and LES pressure.
    • The open approach had significantly higher rates of wound and respiratory complications (p <0.001, p <0.05).
    • Postoperative dysphagia rates were similar, but open surgery resulted in more postprandial epigastric fullness and bloating (p <0.05, p <0.01).

    Conclusions:

    • Laparoscopic and open Nissen fundoplication demonstrate comparable effectiveness in GERD control.
    • The open technique is linked to increased surgical site infections, respiratory issues, and early digestive discomfort.
    • Dysphagia rates are similar, but laparoscopic surgery may offer advantages in reducing early postoperative gastrointestinal symptoms.