Two antireflux operations: floppy versus standard Nissen fundoplication

Area of Science:

• Gastroenterology
• Surgical Innovation
• Patient Outcomes

Background:

• Gastro-oesophageal reflux disease (GERD) is a common condition requiring surgical intervention.
• Nissen fundoplication is a standard surgical procedure for GERD.
• The impact of surgical technique variations, such as fundic mobilization, on postoperative symptoms requires further investigation.

Purpose of the Study:

• To evaluate the effect of fundic mobilization during Nissen fundoplication on belching ability, abdominal gas, bloating, and flatus.
• To compare postoperative outcomes between patients who underwent Nissen fundoplication with and without fundic mobilization.

Main Methods:

• A prospective, randomized study involving 25 patients with refractory GERD.
• Patients were randomized to Nissen fundoplication with or without fundic mobilization.
• Assessment of belching ability, abdominal gas volume, bloating, flatus, and intra-abdominal radioactivity post-surgery.

Main Results:

• Reflux was effectively cured in all patients, irrespective of fundic mobilization.
• Subjective belching ability was restored in 73% of patients with fundic mobilization versus 50% without.
• No significant differences were observed in postoperative bloating or flatus disturbances between the groups.

Conclusions:

• Fundic mobilization in Nissen fundoplication may offer a slight improvement in restoring belching ability.
• Antireflux efficacy is maintained regardless of fundic mobilization.
• Fundic mobilization does not appear to provide additional benefits for managing postoperative flatus or bloating.