[The laparoscopic fundoplication technique and postoperative complications]

The authors performed in the course of 3 years 200 laparoscopic fundoplications on account of oesophageal reflux. Only in one case they used the classical approach and once they converted to the classical procedure. The short-term results are encouraging. The number of complications was comparable with those reported abroad. A complete antireflux effect was achieved in 95% of the operated patients. In the authors opinion the main success of the operation is the sparing dissection of the hiatus, maximum sparing of the vagus innervation, the creation of a sufficiently large window behind the oesophagus and differentiated use of antireflux plastic operations, depending on the preoperative examination and the peroperative finding. The authors prefer the circular Nissen-Rossetti plastic operation, they do not use antitelescopic suture nor severing of the vasa brevia. To prevent penetration of the stomach into the mediastinum they use only in major diaphragmatic defects sparing suture of the hiatus or fixation of the upper suture of the cuff to the top of the hiatus. They resolve major defects by implantation of a net into the hiatus. Their favourable results make, when comparing conservative and surgical treatment, laparoscopic fundoplication the most desirable procedure.