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Laparoscopic Nissen fundoplication

G G Jamieson1, D I Watson, R Britten-Jones

  • 1University Department of Surgery, Royal Adelaide Hospital, South Australia.

Annals of Surgery
|August 1, 1994
PubMed
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Laparoscopic Nissen fundoplication shows promise for treating gastroesophageal reflux disease, with most patients experiencing symptom relief. While not yet as established as open surgery, this minimally invasive approach is gaining traction.

Area of Science:

  • Minimally invasive surgery
  • Gastroenterology
  • Surgical techniques

Background:

  • Laparoscopic Nissen fundoplication was performed in 155 patients over 29 months.
  • 137 patients were observed for over 3 months post-procedure.

Purpose of the Study:

  • To present the authors' laparoscopic approach for Nissen fundoplication.
  • To evaluate the outcomes of this technique in a patient cohort.

Main Methods:

  • A 360-degree fundoplication was created using 3-4 sutures.
  • Short gastric vessels were preserved, and the anterior stomach wall was used for the esophageal wrap with a bougie.
  • The procedure was attempted laparoscopically.

Main Results:

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  • Laparoscopic completion was unsuccessful in 19 patients due to unsatisfactory wrap.
  • 10 patients required reoperation within 6 months; one patient died postoperatively.
  • Of 137 patients followed for >3 months, 133 (97%) were symptom-free from reflux.

    • Conclusions:

    • Laparoscopic fundoplication offers advantages comparable to laparoscopic cholecystectomy in uncomplicated cases.
    • While not yet matching open fundoplication's utility, laparoscopic Nissen fundoplication is expected to see increased use for GERD treatment.