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Laparoscopic Nissen fundoplication: where do we stand?
G Perdikis1, R A Hinder, R J Lund
1Dept. of Surgery, Creighton University School of Medicine, Omaha, NE 68131, USA.
Surgical Laparoscopy & Endoscopy
|February 1, 1997
Summary
Laparoscopic Nissen fundoplication offers lower short-term morbidity and mortality compared to open surgery. This minimally invasive approach shows superior outcomes to medical therapy for reflux disease.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Laparoscopic Nissen fundoplication, introduced in 1991, is increasingly performed for gastroesophageal reflux disease.
- Reviewing short-term outcomes is crucial given the rising number of procedures.
Purpose of the Study:
- To evaluate the short-term safety and efficacy of laparoscopic Nissen fundoplication.
- To compare laparoscopic outcomes with historical open procedures and medical management.
Main Methods:
- A retrospective review of published reports on laparoscopic Nissen fundoplication.
- Analysis of data from 2453 patients regarding complications, re-operations, and patient satisfaction.
Main Results:
- Low rates of serious complications: perforation (1.0%), bleeding requiring transfusion (1.1%), pneumothorax (2.0%), splenectomy (0.1%).
- Conversion to open surgery occurred in 5.8%. Early dysphagia affected 20.3%, with late dysphagia in 5.5%.
- High patient satisfaction (87-100%) and superiority over medical therapy were noted.
Conclusions:
- Laparoscopic Nissen fundoplication demonstrates favorable short-term results with reduced morbidity and mortality compared to open surgery.
- While early dysphagia is common, overall outcomes and patient satisfaction are high.
- Further long-term follow-up data is needed to fully assess the procedure's durability.