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Laparoscopic Nissen fundoplication

N Katada1, R A Hinder, F Raiser

  • 1Department of Surgery, Creighton University School of Medicine, Omaha, NE 68131, USA.

The Gastroenterologist
|June 1, 1995
PubMed
Summary
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Laparoscopic Nissen fundoplication is a safe and effective surgical option for severe gastroesophageal reflux disease (GERD) unresponsive to medication. This minimally invasive procedure offers good long-term results and quick recovery for patients with mechanical LES incompetence.

Area of Science:

  • Gastroenterology
  • Surgical Procedures
  • Minimally Invasive Surgery

Background:

  • Gastroesophageal reflux disease (GERD) affects many patients, with some requiring advanced treatment.
  • Severe GERD unresponsive to medical therapy often involves lower esophageal sphincter (LES) mechanical incompetence.
  • Surgical intervention to improve the LES antireflux barrier is a viable option for select patients.

Purpose of the Study:

  • To evaluate the safety and efficacy of laparoscopic Nissen fundoplication for severe GERD.
  • To outline the preoperative evaluation and indications for surgical intervention.
  • To highlight the benefits of a minimally invasive approach for antireflux surgery.

Main Methods:

  • Preoperative assessment including contrast radiography, esophagoduodenoscopy (EGD) with biopsies, esophageal manometry, and 24-hour pH monitoring.

Related Experiment Videos

  • Performance of a short, loose Nissen fundoplication, particularly for patients with normal esophageal motility.
  • Laparoscopic surgical approach for the fundoplication procedure.

    • Main Results:

    • Laparoscopic Nissen fundoplication is a safe and effective antireflux procedure.
    • Operative complications are infrequent, with common examples including gastric perforation, bleeding, and pneumothorax.
    • Patients typically experience a short hospital stay, often discharged on postoperative day 1 or 2.
    • Follow-up studies demonstrate comparable long-term efficacy to open Nissen fundoplication.

    Conclusions:

    • Laparoscopic Nissen fundoplication provides a safe and effective minimally invasive solution for severe GERD.
    • The procedure offers significant advantages in terms of patient recovery and hospital stay.
    • It achieves comparable long-term outcomes to traditional open surgery for improving LES function.