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Laparoscopic versus conventional fundoplication

C T Frantzides1, M A Carlson

  • 1Department of Surgery, Medical College of Wisconsin, Milwaukee, USA.

Journal of Laparoendoscopic Surgery
|June 1, 1995
PubMed
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Laparoscopic Nissen fundoplication shows comparable operative times to open surgery but significantly reduces hospital stays and complications. This minimally invasive approach offers excellent short-term outcomes for patients with acid reflux.

Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Gastroesophageal reflux disease (GERD) management often involves surgical intervention.
  • Open fundoplication has been the traditional approach.
  • Laparoscopic fundoplication offers a minimally invasive alternative.

Purpose of the Study:

  • To compare the operative and short-term outcomes of open fundoplication versus laparoscopic fundoplication.
  • To evaluate patient recovery, complication rates, and symptom resolution.

Main Methods:

  • Retrospective comparison of 29 patients undergoing open fundoplication and 36 patients undergoing laparoscopic fundoplication.
  • Data collected included operative time, length of hospital stay, and complication rates.

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  • Postoperative evaluation involved barium swallow, esophago-gastroduodenoscopy (EGD), and assessment of reflux symptoms over a 3-32 month follow-up period.

    • Main Results:

    • Operative times were comparable: 2.8 +/- 0.4 hours (open) vs. 3.1 +/- 0.3 hours (laparoscopic).
    • Hospital stay was significantly shorter for laparoscopic: 1.8 +/- 0.2 days vs. 9.2 +/- 0.7 days (open).
    • Complication rates were lower in the laparoscopic group (1 vs. 5).
    • All patients achieved resolution of esophagitis and were symptom-free post-surgery.

    Conclusions:

    • Laparoscopic Nissen fundoplication is a safe and effective alternative to open surgery for GERD.
    • The laparoscopic approach offers significant advantages in terms of reduced hospital stay and fewer complications.
    • Excellent short-term outcomes and symptom resolution are achieved with laparoscopic fundoplication.