Laparoscopic Nissen fundoplication in the infant

Twenty-five children weighing less than 8 kg underwent laparoscopic Nissen fundoplication for treatment of refractory gastroesophageal reflux (GER) between January 1993 and April 1995. Mean patient age was 6 months and weight was 5.1 kg. Mean operative time was 114 min, including gastrostomy in 20 patients. Nineteen patients are alive without evidence of GER with a mean follow-up of 359 days. Perioperative complications were unusual and mild. There were 6 late deaths due to progression of underlying disease and not attributable to the procedure. Laparoscopic Nissen fundoplication provides effective antireflux protection to very small children with acceptable morbidity and mortality through short-term follow-up.