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Laparoscopic fundoplication for gastro-oesophageal reflux
D I Watson1, M W Reed, A G Johnson
1University Surgical Unit, Royal Hallamshire Hospital, Sheffield.
Annals of the Royal College of Surgeons of England
|July 1, 1994
Summary
Laparoscopic Nissen fundoplication is a feasible surgical option for gastro-oesophageal reflux disease. Early results suggest this technique may reduce morbidity compared to open antireflux surgery.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Gastro-oesophageal reflux disease (GERD) management often involves antireflux surgery.
- Open Nissen fundoplication is a traditional approach with associated morbidity.
Purpose of the Study:
- To report the initial experience of surgeons learning laparoscopic Nissen fundoplication.
- To evaluate the feasibility and early outcomes of laparoscopic Nissen fundoplication for GERD.
Main Methods:
- A total of 33 patients underwent laparoscopic Nissen fundoplication.
- Procedures included posterior crural repair in 29 patients and concomitant cholecystectomy in 2.
- Surgeons' learning experience with the technique was documented.
Main Results:
- 33 laparoscopic Nissen fundoplications were performed with 3 conversions to open surgery.
- Two patients required reoperation for slipped fundoplication and esophageal obstruction.
- All patients were symptom-free at follow-up (median 5 months), with median operating time of 81 minutes.
Conclusions:
- Laparoscopic Nissen fundoplication is a feasible technique for GERD.
- Early outcomes suggest reduced morbidity compared to open antireflux surgery.
- A prospective randomized study is underway for further evaluation.