Laparoscopic Rosetti fundoplication

Early experiences with laparoscopic fundoplication using the Rosetti technique are presented and compared with retrospective results from conventional fundoplication procedures.

We have performed 70 consecutive laparoscopic procedures. Conversion to open surgery was done in seven cases because of anatomical reasons and in two because of peroperative progressive subcutaneous emphysema and CO2-retention. The complication rate was low. The range of postoperative hospital stay is 1-4 days for non-converted patients. Symptomatic follow-up has hitherto been performed in 41 patients with a follow-up time of 3-9 months. The follow-up results do not differ from those achieved in patients operated upon with the conventional open Nissen (n = 41) and Rosetti (n = 36) techniques. Pre- and postoperative control of 24 h pH and lower esophageal sphincter pressure (LESP) in 19 laparoscopically treated patients showed normalization of LESP in all cases and postoperative 24 h pH < 4 ranging between 0 and 3%.

Laparoscopic and reflux surgery is effective for the treatment of reflux esophagitis. Follow-up results compare well with open surgery.