A study of fundoplication disruption and deformity

Area of Science:

• Gastroenterology and Surgical Procedures
• Medical Device and Implant Technology

Background:

• Nissen fundoplication is a common surgical procedure for gastroesophageal reflux disease (GERD).
• Postoperative complications can occur, necessitating understanding of potential failure modes.

Observation:

• This study reports on three patients experiencing a novel form of Nissen fundoplication failure.
• The complication involved a proximal gastric pouch deformity leading to partial gastric outlet obstruction.

Findings:

• Disruption and recurrent reflux are the most frequent postoperative issues following Nissen fundoplication.
• A rare proximal gastric pouch deformity, distinct from recurrent herniation, was identified in three patients.
• Two of the three patients with this deformity required revision surgery.

Implications:

• Recognizing this rare gastric pouch deformity is crucial for accurate diagnosis and management of Nissen fundoplication failures.
• Further research may elucidate the specific mechanisms leading to this type of obstruction.
• This finding may inform surgical technique modifications to minimize the risk of gastric pouch deformity.