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Published on: August 15, 2025
Day-case laparoscopic Nissen fundoplication in children.
Behrouz Banieghbal1, Peter Beale
1Department of Pediatric Surgery, CH Baragwnath Hospital, University of the Witwatersrand, Johannebsurg, Republic of South Africa. banieghbal@worldonline.co.za
Summary
Day-case laparoscopic Nissen fundoplication is a safe and acceptable procedure for children with gastroesophageal reflux disease. This study shows feasibility and high patient satisfaction for pediatric reflux surgery as an outpatient procedure.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Anesthesiology
Background:
- Gastroesophageal reflux disease (GERD) is a common condition in children.
- Laparoscopic Nissen fundoplication is a surgical treatment for GERD.
- Day-case surgery aims to reduce hospital stay and improve patient experience.
Purpose of the Study:
- To evaluate the safety and acceptability of day-case laparoscopic Nissen fundoplication in pediatric patients.
- To determine the feasibility of outpatient surgical management for GERD in children.
Main Methods:
- Retrospective analysis of pediatric patients undergoing laparoscopic Nissen fundoplication.
- Selection of patients meeting specific criteria for day-case surgery (age >6 months, ASA grade I/II, adequate home support).
- Standardized anesthetic and analgesic protocols, with postoperative follow-up via telephone and clinic visits at 1 week and 6 months.
Main Results:
- Twenty-one children (31%) were suitable for day-case surgery, with 19 discharged on the same day (average 6.5 hours post-op).
- No readmissions or recurrent symptoms were reported within 6 months.
- Patients and caregivers reported high satisfaction with the procedure, information, and aftercare, with a willingness to recommend and repeat the day-case approach.
Conclusions:
- Day-case laparoscopic Nissen fundoplication is feasible and safe in select pediatric patients.
- The procedure is well-accepted by both children and their caregivers.
- This approach offers a viable alternative for managing pediatric GERD, potentially reducing healthcare costs and improving patient satisfaction.
