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Related Experiment Videos

Laparoscopic Nissen fundoplication--200 consecutive cases

D C Gotley1, B M Smithers, M Rhodes

  • 1University of Queensland, Department of Surgery, Princess Alexandra Hospital, Australia.

Gut
|April 1, 1996
PubMed
Summary

Laparoscopic Nissen fundoplication effectively treats gastro-oesophageal reflux disease. This surgical approach improved symptoms and reduced acid exposure, with outcomes enhancing as surgeon experience grew.

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Area of Science:

  • Gastroenterology
  • Minimally Invasive Surgery
  • Surgical Outcomes

Background:

  • Gastro-oesophageal reflux disease (GERD) significantly impacts patient quality of life.
  • Surgical intervention, such as Nissen fundoplication, is a treatment option for refractory GERD.
  • Laparoscopic techniques offer potential advantages over open procedures.

Purpose of the Study:

  • To evaluate the safety and efficacy of laparoscopic Nissen fundoplication for GERD.
  • To assess the impact of surgical experience on operative outcomes.
  • To analyze short-term symptomatic and objective reflux control post-surgery.

Main Methods:

  • A cohort of 200 patients underwent laparoscopic Nissen fundoplication between 1991 and 1994.
  • Pre-operative assessments included symptom scoring, endoscopy, manometry, and 24-hour esophageal pH monitoring.

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  • Post-operative evaluations involved symptom scoring and repeat pH monitoring at 3-6 months for a subset of patients.

    • Main Results:

    • The second 100 patients experienced significantly shorter operative times (120 vs. 155 minutes) and hospital stays (3 vs. 3 days) compared to the first 100.
    • Conversion rates to laparotomy (2% vs. 7%) and overall morbidity (7% vs. 16%) were lower in the second cohort.
    • Significant reductions in median symptom scores (5/9 to 0/9) and 24-hour esophageal acid exposure (10% to 1%) were observed post-fundoplication.

    Conclusions:

    • Laparoscopic Nissen fundoplication is a safe and effective treatment for GERD.
    • Surgical proficiency leads to improved operative efficiency and reduced hospital stay.
    • The procedure consistently yields positive short-term symptomatic and objective improvements in GERD management.