[Reoperation following Nissen fundoplication]

The main causes of unsatisfactory results after Nissen fundoplication can usually be explained by tactical and technical mistakes. The fixation of the stomach to the diaphragm is one case of the development of pain syndrome, telescopic phenomenon and relative or complete dispersion of fundoplication with subsequent development of a recurrent reflux oesophagitis. The fundoplication should be done only in hospitals which have experience in oesophageal and gastric surgery. The collar of fundoplication should be formed with the two sides (the anterior and the posterior) of the stomach after extensive mobilisation of the cardia region. The operation includes the obligatory fixation of the collar to the oesophagus in order to avoid complications like pain syndrome, sliding of the collar and recurrent reflux oesophagitis.