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Anterior 180° partial fundoplication--how I do it
Piers A C Gatenby1, Tim Bright, David I Watson
1Flinders University Department of Surgery, Flinders Medical Centre, Bedford Park, Adelaide, South Australia, 5042, Australia.
Summary
An anterior 180° partial fundoplication effectively controls gastro-oesophageal reflux with fewer side effects than standard operations. This surgical technique offers a viable alternative for reflux management.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Reflux Management
Background:
- Laparoscopic Nissen fundoplication is a standard surgical treatment for gastro-oesophageal reflux.
- This procedure can lead to troublesome side effects in some patients.
- Partial fundoplications are recommended to minimize these risks.
Purpose of the Study:
- To describe the surgical approach for an anterior 180° partial fundoplication.
- To highlight its efficacy in reflux control and reduction of side effects.
Main Methods:
- The procedure involves full dissection of the oesophageal hiatus.
- Hiatal repair is performed with posteriorly placed sutures.
- An anterior 180° partial fundoplication is constructed using five sutures.
Main Results:
- Randomised trials and outcome studies confirm effective reflux control.
- This approach demonstrates a reduced incidence of side effects compared to full fundoplication.
- The described technique ensures secure attachment of the gastric fundus.
Conclusions:
- Anterior 180° partial fundoplication is an effective method for surgical reflux control.
- It offers a favorable balance between efficacy and patient side effect profile.
- This technique represents a valuable option in the surgical management of gastro-oesophageal reflux disease.
