Laparoscopic Nissen-Rossetti fundoplication. First results

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery

Background:

• Gastroesophageal reflux disease (GERD) and hiatal hernias are common conditions requiring surgical intervention.
• Traditional open fundoplication has demonstrated efficacy but involves significant patient morbidity.

Purpose of the Study:

• To evaluate the safety and efficacy of laparoscopic Nissen-Rossetti fundoplication for GERD and hiatal hernia.
• To assess short-term and mid-term outcomes, including complications and patient satisfaction.

Main Methods:

• A prospective study of 148 patients undergoing laparoscopic Nissen-Rossetti fundoplication between January 1992 and July 1994.
• Data collection included intraoperative complications, postoperative events, hospital stay, and patient-reported outcomes.

Main Results:

• No conversions to open surgery or postoperative deaths were recorded.
• Key intraoperative complications included hemorrhage (n=12), pleural opening (n=5), and gastric perforation (n=1).
• Postoperative issues included bleeding requiring reoperation (n=2) and food impaction (n=2). Dysphagia occurred in 11 patients, with successful management via endoscopic dilatation or further surgery in most cases. Median hospital stay was 4.9 days. Eighty-four percent of patients reported satisfaction.

Conclusions:

• Laparoscopic Nissen-Rossetti fundoplication is a safe and effective procedure for managing symptomatic GERD and hiatal hernias.
• The minimally invasive approach offers comparable outcomes to open surgery with the benefits of reduced invasiveness.
• High patient satisfaction rates support the adoption of this technique.