Related Experiment Video
Updated: Aug 10, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
Effects of partial (Belsey Mark IV) and complete (Nissen) fundoplication on proximal gastric function and
Robert C H Scheffer1, Melvin Samsom, Geoff S Hebbard
1Gastrointestinal Research Unit, Departments of Surgery and Gastroenterology, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Objectives:
This study aimed to assess the effects of Belsey Mark IV 270 degrees (partial) and Nissen 360 degrees (complete) fundoplication on proximal stomach function, transient lower esophageal sphincter relaxation (TLESR) elicitation and the esophagogastric junction (EGJ) pressure profile during TLESR to further elucidate the mechanism of action of fundoplication.
Methods:
Ten patients after partial and 10 patients after complete fundoplication were studied. High-resolution EGJ manometry and pH recording were performed for 1 h at baseline and 2 h following meal ingestion (500 mL/300 kcal). Three dimensional (3D) ultrasonographic images of the stomach were acquired every 15 min after meal ingestion. From the 3D ultrasonographic images, proximal gastric volumes were computed.
Results:
Postprandial proximal to complete gastric volume distribution ratios were larger among patients after partial (0.42 +/- 0.028) compared with patients after complete fundoplication (0.37 +/- 0.035; p < 0.05). Partial fundoplication patients had a markedly greater postprandial rate of TLESR (1.7 +/- 0.3/h) than patients after complete fundoplication (0.8 +/- 0.2/h; p < 0.05). The axial EGJ pressure profile was minimally affected by partial fundoplication but instead markedly changed after complete fundoplication.
Conclusions:
Patients after partial fundoplication exhibit a larger meal-induced increase in proximal stomach volume, a higher TLESR rate, and a minimally affected axial EGJ pressure profile compared to patients after complete fundoplication.
Related Concept Videos
Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Barrett Esophagus-II: Clinical Manifestations and Management
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube through...
Esophageal Achalasia
Esophageal Strictures-II: Clinical Features and Management
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
