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Related Experiment Videos

A modified fundoplication which preserves the ability to belch.

R Menguy

    Surgery
    |September 1, 1978
    PubMed
    Summary

    A modified Nissen fundoplication allows patients to belch freely, avoiding the gas-bloat syndrome common after the conventional procedure. This antireflux surgery shows improved outcomes with fewer complications.

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    Area of Science:

    • Gastroenterology
    • Surgical Innovation
    • Reflux Management

    Background:

    • The Nissen fundoplication is a standard surgical treatment for gastroesophageal reflux disease (GERD).
    • Conventional Nissen fundoplication can lead to complications such as the inability to belch and gas-bloat syndrome.
    • Previous antireflux procedures include those described by Nisse, Belsey, and Hill.

    Purpose of the Study:

    • To describe and evaluate a modified transabdominal antireflux procedure.
    • To compare the outcomes of the modified procedure with the conventional Nissen fundoplication.

    Main Methods:

    • A modified antireflux procedure combining features of Nissen, Belsey, and Hill operations was developed.
    • A comparative study was conducted between 61 patients undergoing conventional Nissen fundoplication and 54 patients undergoing the modified procedure between 1972 and 1976.

    Main Results:

    • All but one patient in the modified plication group could belch freely, with only one instance of recurrent reflux.
    • In contrast, patients undergoing conventional Nissen fundoplication were unable to belch freely, and 15% experienced gas-bloat syndrome.
    • Complete or partial breakdown of the plication occurred in 11% of conventional Nissen cases, often associated with regained ability to belch.

    Conclusions:

    • The modified transabdominal antireflux procedure offers a significant advantage over conventional Nissen fundoplication.
    • This modified approach effectively resolves reflux while preserving the ability to belch and reducing gas-bloat syndrome.
    • The modified procedure demonstrates a lower complication rate and improved patient quality of life for GERD management.

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