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Laparoscopic Nissen fundoplication in children under 2 years of age
1Department of Surgery and Pediatric Surgery, Hadassah University Hospital Mount Scopus, and the Hebrew University-Hadassah Medical School, Jerusalem, 91240 Israel.
Insights
Laparoscopic Nissen fundoplication is a safe and effective surgical option for infants and children experiencing severe gastroesophageal reflux (GER) complications. This minimally invasive approach offers good short-term results for young patients, including those with neurological conditions.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Minimally Invasive Surgery
Background:
- Gastroesophageal reflux (GER) complications necessitate antireflux operations in infants and children.
- Laparoscopic antireflux surgery is increasingly adopted in adult patients.
- This study details the initial experience with laparoscopic Nissen fundoplication in pediatric patients under two years of age.
Purpose of the Study:
- To evaluate the feasibility, safety, and efficacy of laparoscopic Nissen fundoplication in infants and children under two years old.
- To assess the outcomes of this procedure in a pediatric population with significant GER-related complications.
Main Methods:
- Eleven infants and children weighing 3.0–10.0 kg underwent laparoscopic Nissen fundoplication.
- Primary indications included GER-induced aspiration pneumonia and failure to thrive despite conservative management.
- Most patients (10/11) had associated neurological abnormalities, with six diagnosed with familial dysautonomia.
Main Results:
- All laparoscopic Nissen fundoplications were completed successfully.
- The procedure was associated with minimal postoperative complications.
- Acceptable short-term clinical outcomes were observed in this pediatric cohort.
Conclusions:
- Laparoscopic Nissen fundoplication is a feasible, safe, and effective treatment for infants and children with severe GER.
- The technique is well-tolerated even in very young and neurologically impaired patients.
- This approach provides a viable surgical solution for managing complex GER cases in pediatric patients.
Background:
Antireflux operations have been recommended for infants and children suffering from complications related to gastroesophageal reflux (GER). In recent years, the laparoscopic approach has been used increasingly for antireflux surgery in adult patients. This is our initial experience with Nissen fundoplication in infants and children under 2 years of age.
Patients:
We operated on 11 patients weighing between 3.0 and 10.0 kg. The main indications for surgery were GER-induced aspiration pneumonia and failure to thrive, in spite of intensive conservative treatment. All patients except one had an associated neurological abnormality, including six patients with familial dysautonomia.
Results:
All attempted operations were completed successfully laparoscopically, with only a few postoperative complications and acceptable short-term results. The clinical considerations and technical aspects unique to this specific group of patients are discussed.
Conclusion:
Laparoscopic Nissen fundoplication is feasible, safe, and effective, even in very small babies.
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