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Journal articles on the topic 'Laparoscopic fundoplication'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Cowgill, Sarah M., Rachel Gillman, Emily Kraemer, Sam Al-Saadi, Desiree Villadolid, and Alexander Rosemurgy. "Ten-Year Follow up after Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease." American Surgeon 73, no. 8 (August 2007): 748–53. http://dx.doi.org/10.1177/000313480707300803.

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Laparoscopic Nissen fundoplication was first undertaken in the early 1990s. Appreciable numbers of patients with 10-year follow up are only now available. This study assesses long-term outcome and durability of outcome after laparoscopic Nissen fundoplication for treatment of gastro-esophageal reflux disease. Since 1991, 829 patients have undergone laparoscopic fundoplications and are prospectively followed. Two hundred thirty-nine patients, 44 per cent male, with a median age of 53 years (± 15 standard deviation) underwent laparoscopic Nissen fundoplications at least 10 years ago; 28 (12%) patients were “redo” fundoplications. Before and after fundoplication, among many symptoms, patients scored the frequency and severity of dysphagia, chest pain, vomiting, regurgitation, choking, and heartburn using a Likert scale (0 = never/not bothersome to 10 = always/very bothersome). Symptom scores before versus after fundoplication were compared using a Wilcoxon matched-pairs test. Data are reported as median, mean ± standard deviation, when appropriate. After fundoplication, length of stay was 2 days, 3 days ± 4.8. Intra-operative inadvertent events were uncommon and without sequela: 1 esophagotomy, 1 gastrotomy, 3 cardiac dysrhythmias, and 3 CO2 pneumothoraces. Complications after fundoplication included: 1 postpneumonic empyema, 3 urinary retentions, 2 superficial wound infections, 1 urinary tract infection, 1 ileus, and 1 intraabdominal abscess. There were two perioperative deaths; 88 per cent of the patients are still alive. After laparoscopic Nissen fundoplication, frequency and severity scores dramatically improved for all symptoms queried (P < 0.001), especially for heartburn frequency (8, 8 ± 3.2 versus 2, 3 ± 2.8, P < 0.001) and severity (10, 8 ± 2.9 versus 1, 2 ± 2.5, P < 0.001). Eighty per cent of patients rate their symptoms as almost completely resolved or greatly improved, and 85 per cent note they would again have the laparoscopic fundoplication as a result of analysis of our initial experience, thereby promoting superior outcomes in the future. Nonetheless, follow up at 10 years and beyond of our initial experience documents that laparoscopic fundoplication durably provides high patient satisfaction resulting from long-term amelioration of the frequency and severity of symptoms of gastroesophageal reflux disease. These results promote further application of laparoscopic Nissen fundoplication.

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2

Sadowitz, Benjamin D., Kenneth Luberice, Ty A. Bowman, Alexandra M. Viso, Daniel E. Ayala, Sharona B. Ross, and Alexander S. Rosemurgy. "A Single Institutions First 100 Patients Undergoing Laparoscopic Anti-Reflux Fundoplications: Where are They 20 Years Later?" American Surgeon 81, no. 8 (August 2015): 791–97. http://dx.doi.org/10.1177/000313481508100817.

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Although anti-reflux surgery has been used liberally over the past decades for the treatment of gastroesophageal reflux disease (GERD), few studies report follow-up after 10 years. This study was undertaken to report follow-up on 100 consecutive GERD patients up to 22 years after utilizing a laparoscopic fundoplication. Hundred consecutive patients undergoing laparoscopic fundoplication for GERD were prospectively followed beginning in 1992. The frequency and severity of symptoms before and after laparoscopic fundoplication were scored on a Likert scale (1 = never/none to 10 = always/very bothersome). Median data are reported. Of the 100 patients who underwent laparoscopic fundoplication for their GERD, nine were reoperations. Twenty-six patients are deceased on average 11 years after their fundoplications. Seventy-four patients are alive, with 27 patients, actively followed for 19 years after their fundoplications. At most recent follow-up, patients experienced long-term amelioration of symptom frequency and severity after fundoplication (e.g., heartburn frequency = 8–2, severity = 8–1; P < 0.01 for each). Eighty-four per cent of patients rated their symptom frequency as less than once per month. Eighty-eight per cent of patients were satisfied with their postoperative results, and 95 per cent of patients confirmed they would have the operation again knowing what they know now. Long-term follow-up documents high patient satisfaction and durable symptomatic relief up to two decades after laparoscopic fundoplication for GERD. Patients should seek this operation not only for symptomatic relief, but to mitigate the deleterious effects of long-term acid exposure and anti-acid therapy.

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3

Tan, Sanda, and Mark L. Wulkan. "Minimally Invasive Surgical Techniques in Reoperative Surgery for Gastroesophageal Reflux Disease in Infants and Children." American Surgeon 68, no. 11 (November 2002): 989–92. http://dx.doi.org/10.1177/000313480206801110.

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Fundoplication is commonly performed in children suffering from complications of gastroesophageal reflux disease (GERD). Recently laparoscopic fundoplication has become a standard of care for GERD in children. Published reports show that 2.3 to 14 per cent of children require reoperation after failed fundoplication. The purpose of this study is to show the feasibility of minimally invasive surgical (MIS) techniques to treat children after failed fundoplication. A retrospective chart review was performed for all patients who underwent laparoscopic redo fundoplication at Children's Healthcare of Atlanta at Egleston from July 1998 to July 2000. The patients' records were reviewed for age, diagnosis, type and time of initial operation, type and time of redo operation, operative time for redo operation, and complications. Seventeen children (age 3 months to 18 years) had operations for failed fundoplication attempted using MIS techniques. Six of these children were referred after their initial operation performed elsewhere. Nine (53%) were neurologically impaired. Ten (59%) have respiratory complications of GERD. The initial procedures were as follows: One open Nissen fundoplication, two open Thal fundoplications, 13 laparoscopic Nissen fundoplications, and one laparoscopic Toupet fundoplication. The reoperative procedures performed were revision of fundoplication and hiatal hernia repair (13) or hiatal hernia repair only (four). Two patients had concurrent gastric emptying procedures. One procedure was converted to open for technical reasons. One patient developed a pelvic abscess secondary to leakage around the gastrostomy tube. One child had erosion into the esophagus of a Dacron® patch that was used to close a large hiatal defect. Thirteen patients began feeding by the first postoperative day. We conclude that MIS techniques can be applied to reoperative surgery for the treatment of GERD with an acceptable complication rate in this difficult group of patients. Reoperative patients appear to have the same benefits from MIS as patients undergoing their initial procedure.

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4

Cowgill, Sarah M., Dean Arnaoutakis, Desiree Villadolid, Sam Al-Saadi, Demetri Arnaoutakis, Daniel L. Molloy, Ashley Thomas, Steven Rakita, and Alexander Rosemurgy. "Results after Laparoscopic Fundoplication: Does Age Matter?" American Surgeon 72, no. 9 (September 2006): 778–84. http://dx.doi.org/10.1177/000313480607200904.

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Antireflux fundoplications are undertaken with hesitation in older patients because of presumed higher morbidity and poorer outcomes. This study was undertaken to determine if symptoms of gastroesophageal reflux disease (GERD) could be safely abrogated in a high-risk/reward population of older patients. One hundred eight patients more than 70 years of age (range, 70–90 years) underwent laparoscopic Nissen fundoplications undertaken between 1992 and 2005 and were compared with 108 concurrent patients less than 60 years of age (range, 18–59 years) to determine relative outcomes. Before and after fundoplication, patients scored the severity of reflux and dysphagia on a Likert Scale (0 = minor, 10 = severe). Before fundoplication, older patients had lower reflux scores ( P < 0.01), but not lower dysphagia scores or DeMeester scores. One patient (86 years old) died from myocardial infarction; otherwise, complications occurred infrequently, inconsequentially, and regardless of age. At similar durations of follow-up, reflux and dysphagia scores significantly improved ( P < 0.01) for older and younger patients. After fundoplication, older patients had lower dysphagia scores ( P < 0.01) and lower reflux scores ( P < 0.01). At the most recent follow-up, 82 per cent of older patients rated their relief of symptoms as good or excellent. Similarly, 81 per cent of the younger patients reported good or excellent results. Ninety-one per cent of patients 70 years of age or more versus 85 per cent of patients less than 60 years would undergo laparoscopic Nissen fundoplication again, if necessary. With fundoplication, symptoms of GERD improve for older and younger patients, with less symptomatic dysphagia and reflux in older patients after fundoplication. Laparoscopic fundoplication safely ameliorates symptoms of GERD in elderly patients with symptomatic outcomes superior to those seen in younger patients.

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5

Benkoe, Thomas M., Katrin Rezkalla, Lukas Wisgrill, and Martin L. Metzelder. "Is There a Role for Elective Early Upper Gastrointestinal Contrast Study in Neurologically Impaired Children following Laparoscopic Nissen Fundoplication?" Children 8, no. 9 (September 16, 2021): 813. http://dx.doi.org/10.3390/children8090813.

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Assessment of discomfort as a sign for early postoperative complications in neurologically impaired (NI) children is challenging. The necessity of early routine upper gastrointestinal (UGI) contrast studies following laparoscopic Nissen fundoplication in NI children is unclear. We aimed to evaluate the role of scheduled UGI contrast studies to identify early postoperative complications following laparoscopic Nissen fundoplication in NI children. Data for laparoscopic Nissen fundoplications performed in NI children between January 2004 and June 2021 were reviewed. A total of 103 patients were included, with 60 of these being boys. Mean age at initial operation was 6.51 (0.11–18.41) years. Mean body weight was 16.22 (3.3–62.5) kg. Mean duration of follow up was 4.15 (0.01–16.65 years) years. Thirteen redo fundoplications (12.5%) were performed during the follow up period; eleven had one redo and two had 2 redos. Elective postoperative UGI contrast studies were performed in 94 patients (91%). Early postoperative UGI contrast studies were able to identify only one complication: an intrathoracal wrap herniation on postoperative day five, necessitating a reoperation on day six. The use of early UGI contrast imaging following pediatric laparoscopic Nissen fundoplication is not necessary as it does not identify a significant number of acute postoperative complications requiring re-intervention.

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6

Spaniolas, Konstantinos, Richard I. Rothstein, and Thadeus L. Trus. "Transgastric-Assisted Endoscopic Fundoplication." Case Reports in Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/280628.

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Gastroesophageal reflux disease (GERD) is a common entity in the United States. Surgical fundoplication can be performed safely with well-established long-term results. In selected patients with GERD, endoluminal therapy has a potential role. We report on a patient with recurrent GERD after two prior fundoplications who wished to pursue endoscopic treatment. The presence of a gastrostomy tube allowed for the performance of a transgastric-assisted endoluminal fundoplication using the EndoCinch (TM) device and standard pediatric laparoscopic instruments. Symptomatic relief of GERD with EndoCinch (TM) is common but the long-term outcomes are limited. Nevertheless, the EndoCinch (TM) device remains a method for endoscopic suturing in certain settings. In patients with gastrostomy access, the use of laparoscopic instruments may further enable the performance of advanced endoscopic therapies.

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7

Ruiz-Tovar, Jaime, Maria Diez-Tabernilla, Alejandro Chames, Vicente Morales, Alfonso Sanjuanbenito, and Enrique Martinez-Molina. "Clinical Outcome at Ten Years after Laparoscopic Fundoplication: Nissen versus Toupet." American Surgeon 76, no. 12 (December 2010): 1408–11. http://dx.doi.org/10.1177/000313481007601228.

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Laparoscopic surgery has become the elective approach for the surgical treatment of gastroesophageal reflux disease in the last decade. Outcome data beyond 10 years are available for open fundoplication, with good-to-excellent results, but few studies report long-term follow-up after laparoscopic fundoplication. We performed a retrospective study of all the patients that underwent laparoscopic Nissen and Toupet fundoplications as antireflux surgery between 1995 and 1998 in our institution. To evaluate the long-term results, a face-to-face interview was performed in 2009. One hundred and six patients were included in the study. Surgical techniques performed were Nissen fundoplication (NF) in 56 patients and Toupet (TF) in 50. Complication rate was 4 per cent in both groups (nonsignificant [NS]). Two patients (4%) of NF required reoperation because of dysphagia. After 10 years, 10 per cent of the patients remain symptomatic in both groups. Fifteen per cent of NF take daily inhibitors of the proton pump versus 14 per cent of TF (NS). Twenty per cent of NF refer dysphagia, all of them without evidence of stenosis at endoscopy or contrasted studies. The satisfaction rate of the patients was 96 per cent in NF and 98 per cent in TF. Laparoscopic Toupet fundoplication seems to be as safe and long-term effective as Nissen, but with a lower incidence of postoperative dysphagia. In our experience Toupet fundoplication should be the elective approach for the surgical treatment of gastroesophageal reflux disease.

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8

Maish, Mary, and Jeffrey A. Hagen. "Laparoscopic fundoplication." Operative Techniques in Thoracic and Cardiovascular Surgery 9, no. 2 (2004): 115–28. http://dx.doi.org/10.1053/j.optechstcvs.2004.05.003.

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9

Georgeson, Keith E. "Laparoscopic fundoplication." Current Opinion in Pediatrics 10, no. 3 (June 1998): 318–22. http://dx.doi.org/10.1097/00008480-199806000-00018.

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10

MEDINA, LAURA T., RAFAEL VEINTIMILLA, MARK D. WILLIAMS, and MICHAEL E. FENOGLIO. "Laparoscopic Fundoplication." Journal of Laparoendoscopic Surgery 6, no. 4 (August 1996): 219–26. http://dx.doi.org/10.1089/lps.1996.6.219.

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11

Lahmann, Brian E., Carl A. Weiss, Gina L. Adrales, Michael J. Mastrangelo, and Adrian Park. "Laparoscopic fundoplication." Current Surgery 60, no. 1 (January 2003): 43–46. http://dx.doi.org/10.1016/s0149-7944(02)00694-3.

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12

Markus, P. M., O. Horstmann, C. Kley, T. Neufang, and H. Becker. "Laparoscopic fundoplication." Surgical Endoscopy And Other Interventional Techniques 16, no. 1 (October 19, 2001): 48–53. http://dx.doi.org/10.1007/s00464-001-9054-1.

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13

THOMPSON, W. RALEIGH. "Laparoscopic Fundoplication." Pediatric Endosurgery & Innovative Techniques 2, no. 4 (January 1998): 181–84. http://dx.doi.org/10.1089/pei.1998.2.181.

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14

Livingston, Charles D., H. Lamar Jones, Robert E. Askew, Brant E. Victor, and Robert E. Askew. "Laparoscopic Hiatal Hernia Repair in Patients with Poor Esophageal Motility or Paraesophageal Herniation." American Surgeon 67, no. 10 (October 2001): 987–91. http://dx.doi.org/10.1177/000313480106701016.

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Laparoscopic repair for gastroesophageal reflux disease is now an accepted therapy. However, controversy exists with regard to the choice of operation between complete 360-degree Nissen fundoplication versus partial 270-degree Toupe fundoplication. In addition there is some controversy with regard to the proper choice of operation in patients with poor esophageal motility. Another class of hiatal hernia patients are those patients with paraesophageal herniation. Questions regarding the approach to these patients include whether or not to use a reflux procedure at the time of repair and the role of mesh in repair of these large hernias. This retrospective study was undertaken to compare the results of laparoscopic Nissen fundoplication and Toupe fundoplication in patients with both normal and abnormal esophageal motility. In addition the subset of patients with paraesophageal herniation was studied in an effort to ascertain the best surgical approach in these patients. In this study a retrospective analysis was performed on 188 consecutive patients during the period 1995 to 2001. All patients who presented with hiatal hernia surgical problems during this period were included. Endoscopy was performed in all patients with esophageal reflux. Manometry was performed in all patients except those presenting as emergency incarcerations. pH probe testing was performed in those patients in whom it was deemed necessary to establish the diagnosis. Upper gastrointestinal radiographs were used to define anatomy in paraesophageal hernia patients when possible. All patients with esophageal reflux were first treated with a trial of medical therapy. Patients with esophageal reflux and normal esophageal motility underwent 360-degree Nissen fundoplication. Those patients with poor esophageal motility (less than 65 mm of mercury) underwent laparoscopic 270-degree Toupe fundoplication. Patients presenting with paraesophageal herniation underwent laparoscopic repair. When possible esophageal manometry was performed on these patients preoperatively and if normal peristalsis was documented a Nissen fundoplication was performed. If poor esophageal motility was documented before surgery a Toupe fundoplication was performed. Mesh reinforcement of the diaphragmatic hiatus was used if necessary to complete a repair without tension. Patients were followed both by their primary gastroenterologist and their surgeon. Follow-up studies including endoscopy, pH probe, and upper gastrointestinal series were used as necessary in the postoperative period to document any problems as they occurred. Of the 188 patients in the study 141 patients underwent Nissen fundoplication, 21 patients underwent Nissen fundoplication and repair of paraesophageal hernia, 15 underwent Toupe fundoplication, seven underwent Toupe and paraesophageal hernia repair, and four paraesophageal hernia repair alone. One hundred eighty-three patients underwent a laparoscopic operation. Five patients of the 188 underwent an initial open operation—two of these patients because of the size of their paraesophageal hernia. Three of these patients had reoperations of remote operations done years before at other institutions. Twenty-two patients with poor esophageal motility (11.7 %) were included in the study. Fifteen patients required Toupe fundoplication whereas seven patients required Toupe fundoplication and repair of paraesophageal hernias. Mesh repair of paraesophageal hernias was accomplished in ten patients. Patients undergoing Toupe fundoplication had a 13 per cent dysphagia rate less than 4 weeks postoperatively and a 0% dysphagia rate greater than four weeks postoperatively. Patients undergoing Nissen fundoplication had a 16 per cent dysphagia rate less than 4 weeks postoperatively, 2 per cent dysphagia rate greater than 4 weeks postoperatively and no dysphagia at 6 weeks postoperatively. Recurrent symptomatic reflux occurred in 1.4 per cent of Nissen fundoplications and 6.7 per cent of Toupe fundoplications. Of Nissen and paraesophageal repairs 14.2 per cent had reflux and 14.3 per cent of Toupe and paraesophageal repairs had recurrent symptomatic reflux. Overall, complication rate was low. Use of mesh to repair large paraesophageal hernias resulted in a recurrence rate of 0 per cent. There was no instance of infection or bowel fistulization related to the use of mesh. We conclude that laparoscopic Nissen fundoplication in patients with normal esophageal motility is associated with a low rate of dysphagia and a low rate of recurrent reflux. Toupe fundoplication when used in reflux patients with poor esophageal motility is associated with a low rate of dysphagia and an acceptable rate of recurrent reflux. Laparoscopic repair of large paraesophageal herniation when combined with an appropriate antireflux procedure and mesh when needed is an effective treatment with low recurrence rate.

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Coster, D. D., W. H. Bower, V. T. Wilson, R. T. Brebrick, and G. L. Richardson. "Laparoscopic partial fundoplication vs laparoscopic Nissen-Rosetti fundoplication." Surgical Endoscopy 11, no. 6 (February 7, 1997): 625–31. http://dx.doi.org/10.1007/s004649900408.

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16

Triantafyllou, Tania, Georgia Doulami, Charalampos Theodoropoulos, Georgios Zografos, and Dimitrios Theodorou. "PS01.005: HIGH-RESOLUTION MANOMETRY GUIDING SURGICAL PROCEDURE FOR TREATMENT OF ACHALASIA OF THE ESOPHAGUS. LONG-TERM RESULTS OF A PROSPECTIVE STUDY." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 51. http://dx.doi.org/10.1093/dote/doy089.ps01.005.

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Abstract Background Laparoscopic myotomy and fundoplication for the treatment of achalasia presents with 90% success rate. The intraoperative use of manometry during surgery has been previously introduced to improve the outcome. Recently, we presented our pilot study proposing the use of the HRM during surgery. The aim of this study is to evaluate the long-term outcome of the intraoperative use of High-Resolution Manometry (HRM) in achalasia patients. Methods In this prospective study, consecutive achalasia patients underwent laparoscopic myotomy and fundoplication along with real-time use of HRM. Eckardt scores (ES) and HRM results were collected before and after surgery. Results Twenty-three achalasia patients (22% Type I, 57% Type II, 22% Type III, according to Chicago Classification v3.0) with a mean age 48 years underwent calibrated and uneventful myotomy and fundoplication. Eleven myotomies were further extended, while sixteen fundoplications were intraoperatively modified, according to manometric findings. During postoperative follow-up, mean resting and residual pressures of the LES were significantly decreased after surgery (16,1 vs. 41,9, P = 0 and 9 vs. 28,7, P = 0, respectively). The ES was also diminished (1 vs. 7, P = 0). Conclusion The intraoperative use of HRM during laparoscopic myotomy and fundoplication for the treatment of achalasia of the esophagus is a safe, promising and efficient approach aiming to individualize both myotomy and fundoplication for each achalasia patient. Disclosure All authors have declared no conflicts of interest.

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Sharapov, T. L., M. V. Burmistrov, E. I. Sigal, A. A. Moroshek, A. I. Ivanov, A. V. Berdnikov, and A. M. Sigal. "The modern way to prevent complications in laparoscopic antireflux surgery." Kazan medical journal 93, no. 6 (December 15, 2012): 875–79. http://dx.doi.org/10.17816/kmj2095.

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Aim. To improve the results of surgery on patients with hiatus hernia. Methods. Case histories of patients who underwent surgeries at the department of gastric and esophageal surgery from 1996 to 2011 were analyzed. 626 laparoscopic fundoplications in patients aged form 15 to 78 years were performed, among them - 57 using transillumination with fiber optic sensor tube. All patients were present with signs typical for hiatus hernia and gastroesophageal reflux disease (heartburn, belching, early satiety, epigastric discomfort etc.). Pre-surgical examination included X-ray and esophagogastroduodenoscopy. Most patients underwent Nissen fundoplication. The surgery duration varied from 30 to 180 minutes (mean time 65 minutes). Results. Surgical complications such as hollow organs perforation were registered in 4,3% of cases (27 cases out of 626 surgeries). No such complications were registered in group where surgery was performed using transillumination with fiber optic sensor tube. In 12 cases laparotomy for perforation closure was required, in other 15 cases perforation was closed using laparoscopy. No serious events were registered in early post-surgical period, with all patients discharged from the hospital at days 5-7. Such complications as dysphagia and gas-bloat syndrome were predominant in early post-surgical period after laparoscopic fundoplication. The incidence of the early post-surgical complications in patients who underwent surgery without transillumination with fiber optic sensor tube was: dysphagia - 28,8% (164 out of 569 patients), gas-bloat syndrome - 23,7% (135 patients). In cases when transillumination with fiber optic sensor tube was used, dysphagia was diagnosed in 1 case (1,8%), gas-bloat syndrome - in 9 (15,8%) cases. The incidence of late post-surgical complications including dysphagia, relapses and situations when fundoplication becomes undone over time: without transillumination with fiber optic sensor tube - 10,2% (58 out of 569 patients), using transillumination with fiber optic sensor tube - 3,5% (2 out of 57 patients). Conclusion. Preliminary results show that using transillumination with fiber optic sensor tube in laparoscopic fundoplication in patients with hiatus hernia reduces the incidence of post-surgical complications.

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Rosemurgy, Alexander S., Dean J. Arnaoutakis, Donald P. Thometz, Odion Binitie, Natalie B. Giarelli, Mark Bloomston, Steve G. Goldin, and Michael H. Albrink. "Reoperative Fundoplications are Effective Treatment for Dysphagia and Recurrent Gastroesophageal Reflux." American Surgeon 70, no. 12 (December 2004): 1061–67. http://dx.doi.org/10.1177/000313480407001206.

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With wide application of antireflux surgery, reoperations for failed fundoplications are increasingly seen. This study was undertaken to document outcomes after reoperative fundoplications. Sixty-four patients, 26 men and 38 women, of average age 55 years ± 15.6 (SD), underwent reoperative antireflux surgery between 1992 and 2003. Fundoplication prior to reoperation had been undertaken via celiotomy in 27 and laparoscopically in 37. Both before and after reoperative antireflux surgery, patients scored their reflux and dysphagia on a Likert Scale (0 = none, 10 = continuous). Reoperation was undertaken because of dysphagia in 16 per cent, recurrent reflux in 52 per cent (median DeMeester Score 52), or both in 27 per cent. Failure leading to reoperation was due to hiatal failure in 28 per cent, wrap failure in 19 per cent, both in 33 per cent, and slipped Nissen fundoplication in 20 per cent. Laparoscopic reoperations were completed in 49 of 54 patients (91%); 15 had reoperations undertaken via celiotomy. Eighty-eight per cent of reoperations were Nissen fundoplications. With reoperation, Dysphagia Scores improved from 9.5 ± 0.7 to 2.6 ± 2.8, and Reflux Scores improved from 9.1 ± 1.4 to 1.8 ± 2.7. Seventy-nine per cent of patients with reflux prior to reoperation, 100 per cent with dysphagia, and 74 per cent with both noted excellent or good outcomes after reoperation. We conclude that failure after fundoplication occurs. Reoperations reduce the severity of dysphagia and reflux, thus salvaging excellent and good outcomes in most. Laparoscopic reoperations are generally possible. Reoperative fundoplications are effective treatment for dysphagia and recurrent gastroesophageal reflux, and their application is encouraged.

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Endzinas, Žilvinas, Jelena Jončiauskienė, Antanas Mickevičius, and Mindaugas Kiudelis. "Hiatal hernia recurrence after laparoscopic fundoplication." Medicina 43, no. 1 (December 23, 2006): 27. http://dx.doi.org/10.3390/medicina43010003.

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Objectives. To determine the influence of hiatal hernia size and the laparoscopic fundoplication technique on the rate of hernia recurrence. Patients and methods. The preoperative, operative, and postoperative observational data of 381 patients operated on at the Department of Surgery of Kaunas University of Medicine during the period of 1998–2004 for hiatal hernia complicated with gastroesophageal reflux were analyzed. The surgery technique (Nissen or Toupet operation) was chosen independently of the hernia size. The radiological investigation of the esophagus–stomach using barium contrast as well as esophagogastroduodenoscopy and biopsy was performed for all patients before the surgery. The subjective and objective assessment of the patients’ health status was investigated before and no less than 12 months after surgery. If the disease symptoms remained or new ones (i.e. pain behind the sternum, dysphagia, etc.) occurred after surgery, the hernia recurrence was suspected. The radiological investigation of the esophagus–stomach using barium contrast, as well as esophagogastroduodenoscopy and biopsy were performed at the consultative outpatient clinic. The hernia recurrence was confirmed after performing these two investigations. When analyzing the results, the patients were divided into two groups: Group 1 – patients with small hiatal hernia (grade 1 and 2 hernia according to radiological classification), Group 2 – patients with large hiatal hernia (grade 3 and 4 hernia according to radiological classification). Results. A total of 272 (71.4%) patients had small hiatal hernia, and 109 (28.6%) patients had large ones. Hernia recurrence was diagnosed in 7 (2.58%) patients in Group 1, while in Group 2, 11 (10.1%) patients had hernia recurrence (P<0.05). Laparoscopic Nissen fundoplication was performed in 287 (75.4%) patients, after which 14 (4.98%) patients had hernia recurrence, while Toupet fundoplication was performed in 94 (24.6%) patients, after which 4 (4.3%) patients had hernia recurrence (P>0.05). Conclusions. The recurrence rate of hiatal hernia after laparoscopic fundoplications is significantly higher in patients with large hernias (grade 3 and 4 according to radiological classification). The surgery technique (Nissen or Toupet fundoplication) was not a significant factor affecting the recurrence rate of hiatal hernia.

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Hopkins, Roy, Tanya Irvine, Glyn Jamieson, Peter Devitt, and David Watson. "FA04.01: TEN-YEAR FOLLOW-UP OF A MULTICENTRE, DOUBLE-BLIND RANDOMISED CONTROLLED TRIAL OF LAPAROSCOPIC NISSEN VS ANTERIOR 90° PARTIAL FUNDOPLICATION." Diseases of the Esophagus 31, Supplement_1 (September 1, 2018): 7–8. http://dx.doi.org/10.1093/dote/doy089.fa04.01.

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Abstract Background Nissen fundoplications have been reported to have various side effects, which have led to modifications, including partial fundoplications such as anterior 90° wrap. Five-year follow up of randomised trials suggest less side effects following anterior 90° partial compared to Nissen fundoplication, although Nissen fundoplication achieved better reflux control. There is, however, limited longer-term outcome data for Nissen versus 90° anterior partial fundoplication. This study determined outcomes of previous randomised control trials at 10 + years follow-up. Methods From 1999 to 2003, 191 patients were enrolled in two randomised trials comparing anterior 90° partial versus Nissen fundoplication, with outcomes available for 155 (78%) at 10 years. Patients completed annual questionnaires assessing dysphagia, heartburn, medications, satisfaction and other symptoms. Visual analogue scales (0–10), a validated dysphagia score (0–45), Visick score (1–5) and yes/no responses were used. The two trials were combined to evaluate long-term outcomes. Results Following anterior 90° fundoplication patients reported less dysphagia to liquids (0.8 vs 1.8, P = 0.032) and solids (2.0 vs 3.3, P = 0.015). Dysphagia assessed using the 0–45 scale was also less following anterior 90° fundoplication (7.6 vs 12.7, P = 0.023). There was no significant difference in heartburn scores (2.8 vs 1.9 P = 0.053), although more patients were consuming PPIs following anterior 90° fundoplication at 10 years (43.8% vs 20.0% P = 0.004). Overall satisfaction scores were similar for both groups (7.9 vs 7.5, P = 0.215), and the majority considered their original decision for surgery to be correct (78.1% vs. 84.6%, P = 0.387). Reoperation rates were similar (anterior 90° - 13.7% vs Nissen 10.8%, P = 0.796). Conclusion At 10 years follow up, both procedures achieved similar overall success rates as measured by global satisfaction measures, but with more dysphagia following Nissen fundoplication, versus a higher rate of PPI consumption after anterior 90° fundoplication. Heartburn symptom differences failed to reach statistical significance. Disclosure All authors have declared no conflicts of interest.

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Toomey, Paul, Anthony Teta, Krishen Patel, Sharona Ross, Prashant Sukharamwala, and Alexander S. Rosemurgy. "Transoral Incisionless Fundoplication: Is it as Safe and Efficacious as a Nissen or Toupet Fundoplication?" American Surgeon 80, no. 9 (September 2014): 860–67. http://dx.doi.org/10.1177/000313481408000918.

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Transoral incisionless fundoplication (TIF) was U.S. Food and Drug Administration-approved in 2007 to treat gastroesophageal reflux disease (GERD), but comparative data are lacking. This study was undertaken to compare outcomes for patients with GERD undergoing TIF versus laparoscopic Nissen or Toupet fundoplications. We undertook a case-controlled study of three cohorts of 20 patients undergoing TIF or laparoscopic Nissen or Toupet fundoplications from 2010 to 2013 controlling for age, body mass index, and preoperative DeMeester scores. All patients were pro-spectively followed. Median data are reported. Patients undergoing TIF had significantly shorter operative times (in minutes: 71 vs 119 and 85, respectively, P < 0.001) and length of stay (in days: 1, 2, and 1, respectively, P < 0.001). No matter the approach, patients reported dramatic and similar reduction in symptom frequency and severity (e.g., heartburn 8 to 0, P < 0.05). At follow-up, 83 per cent of patients after TIF, 80 per cent after Nissen, or 92 per cent after Toupet fundoplications had symptoms less than once per month ( P = 0.12). TIF leads to dramatic symptom resolution, similar when compared with Nissen or Toupet fundoplications. TIF promotes shorter operative times and lengths of stay. Patient satisfaction and effective palliation of symptoms show that TIF is safe and efficacious in comparison to Nissen and Toupet fundoplications and support its continued application and evaluation.

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Hallerbäck, B., H. Glise, and B. Johansson. "Laparoscopic Rosetti Fundoplication." Scandinavian Journal of Gastroenterology 30, sup208 (January 1995): 58–61. http://dx.doi.org/10.3109/00365529509107763.

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French, Gavin, and Leena Khaitan. "Laparoscopic Nissen Fundoplication." Operative Techniques in General Surgery 8, no. 3 (September 2006): 119–26. http://dx.doi.org/10.1053/j.optechgensurg.2006.09.003.

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Buyske, Jo. "Laparoscopic Nissen Fundoplication." Operative Techniques in General Surgery 9, no. 3 (September 2007): 95–103. http://dx.doi.org/10.1053/j.optechgensurg.2007.09.002.

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Teh, Swee H., and John G. Hunter. "Laparoscopic Nissen Fundoplication." Operative Techniques in Thoracic and Cardiovascular Surgery 11, no. 3 (2006): 218–31. http://dx.doi.org/10.1053/j.optechstcvs.2006.08.002.

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Jamieson, Glyn G., David I. Watson, Robert Britten-Jones, Phlip C. Mitchell, and Mehran Anvari. "Laparoscopic Nissen Fundoplication." Annals of Surgery 220, no. 2 (August 1994): 137–45. http://dx.doi.org/10.1097/00000658-199408000-00004.

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NOWZARADAN, YOUNAN, and PEYTON BARNES. "Laparoscopic Nissen Fundoplication." Journal of Laparoendoscopic Surgery 3, no. 5 (October 1993): 429–38. http://dx.doi.org/10.1089/lps.1993.3.429.

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Allen, Mark S. "Laparoscopic Nissen fundoplication." Operative Techniques in General Surgery 2, no. 1 (March 2000): 4–14. http://dx.doi.org/10.1053/gs.2000.5730.

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Csendes, Attila. "Laparoscopic Nissen fundoplication." Surgery 164, no. 5 (November 2018): 1126–34. http://dx.doi.org/10.1016/j.surg.2018.03.003.

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Wenck, Christopher, and Carsten Zornig. "Laparoscopic Toupet fundoplication." Langenbeck's Archives of Surgery 395, no. 4 (March 31, 2010): 459–61. http://dx.doi.org/10.1007/s00423-010-0637-y.

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Anvari, Mehran, and Christopher Allen. "Laparoscopic Nissen Fundoplication." Annals of Surgery 227, no. 1 (January 1998): 25–32. http://dx.doi.org/10.1097/00000658-199801000-00004.

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Hunter, John G., C. Daniel Smith, Gene D. Branum, J. Patrick Waring, Thadeus L. Trus, Michael Cornwell, and Kathy Galloway. "Laparoscopic Fundoplication Failures." Annals of Surgery 230, no. 4 (October 1999): 595. http://dx.doi.org/10.1097/00000658-199910000-00015.

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Reardon, P. R., T. Scarborough, B. Matthews, A. Preciado, J. L. Marti, and F. C. Brunicardi. "Laparoscopic Nissen fundoplication." Surgical Endoscopy 14, no. 3 (March 2000): 298–99. http://dx.doi.org/10.1007/s004640000071.

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Milford, M. A., and T. A. Paluch. "Ambulatory laparoscopic fundoplication." Surgical Endoscopy 11, no. 12 (December 1997): 1150–52. http://dx.doi.org/10.1007/s004649900558.

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Stefanidis, Dimitrios, James R. Korndorffer, and Daniel J. Scott. "Robotic laparoscopic fundoplication." Current Treatment Options in Gastroenterology 8, no. 1 (February 2005): 71–83. http://dx.doi.org/10.1007/s11938-005-0053-5.

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36

Lafullarde, Thiery. "Laparoscopic Nissen Fundoplication." Archives of Surgery 136, no. 2 (February 1, 2001): 180. http://dx.doi.org/10.1001/archsurg.136.2.180.

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Turchi, Matías J., Felipe E. Fiolo, María Tosti, José I. Paladini, Nicolás Laborda Sirabo, and Priscilla V. López. "Bypass en Y-de-Roux sobre una funduplicatura de Nissen." Revista Argentina de Cirugía 111, no. 2 (June 1, 2019): 95–98. http://dx.doi.org/10.25132/raac.v111.n1.1394.es.

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Roux-en-Y gastric bypass (RYGB) effectively treats both obesity and gastroesophageal reflux disease (GERD). Unfortunately, some patients finally present for bariatric surgery have previously undergone Nissen fundoplication due to GERD. Conversion to EYGB after Nissen fundoplication is safe and effective, but is associated with greater morbidity and longer operative time and hospital stay. A 50-year-old female patient with a body mass index (BMI) of 40.4 kg/m2 was evaluated for bariatric surgery. She had a history laparoscopic Nissen fundoplication seven years before. We report a case of laparoscopic take-down of Nissen fundoplication and conversion to RYGB. A previous fundoplication is not a contraindication for laparoscopic RYGB. These procedures should be performed by well-trained surgeons and laparoscopic approach should be the method of choice.

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Zaporozhan, V. M., and A. V. Malynovskyi. "Experience of application of 3D-visualization in laparoscopic operations." Klinicheskaia khirurgiia 87, no. 1-2 (May 26, 2020): 35–38. http://dx.doi.org/10.26779/2522-1396.2020.1-2.35.

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Objective. Studying of first results of application of 3D visualization in various laparoscopic interventions. Materials and methods. There were performed 169 operations: 27 transabdominal preperitoneal plasties of inguinal hernias, 19 intraperitoneal alloplasties of umbilical and postoperative ventral hernias with suturing of hernia defect, 1 retromuscular alloplasty of umbilical hernia, 6 reconstructions of anterior abdominal wall for dyastasis of rectal abdominal muscles, 103 plasties of hiatal hernias with fundoplications, 7 Heller’s cardiomyotomies and Dor’s fundoplication, 1 subtotal, 3 atypical gastric resections and 2 sleeve gastric resections for obesity. Results. 3D laparoscopy have simplified and accelerated the parietal peritoneum suturing in conduction of transabdominal preperitoneal plasties of inguinal hernias, as well as while performance of intraperitoneal alloplasties of umbilical and postoperative ventral hernias – the hernia defect suturing. While doing the hiatal hernia plasty, fundoplication with crurorrhaphy 3D laparoscopy have provided the additional advantages of manipulations improvement in special anatomic zones. Analogous advantages were shown in gastric operations, using 3D visualization. Intra- and postoperative complications were absent, as well as the hernias recurrence in the 6 mo-1.5 yr follow-up. Conclusion. The 3D visualization guarantees a rapid and highly-precision performance of complex manipulations in technically hard anatomical zones. Further accumulation of the material and comparison of results of 3D and 2D laparoscopy in prospective investigations, using objective parameters, as well as studying of expediency for 3D visualization selective application, for instance while performance of the most complicated operative stages are necessary.

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Van Der Westhuizen, Lionel, Kaitlyn M. Dunphy, Brianna Knott, Alfredo M. Carbonell, Dane E. Smith, and William S. Cobb. "The Need for Fundoplication at the Time of Laparoscopic Paraesophageal Hernia Repair." American Surgeon 79, no. 6 (June 2013): 572–77. http://dx.doi.org/10.1177/000313481307900616.

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Most authors recommend an antireflux operation at the time of laparoscopic paraesophageal hernia (PEH) repair. A fundoplication combats the potential postoperative reflux resulting from disruption of the hiatal anatomy and may minimize recurrence. The purpose of this study is to evaluate the differences in postoperative dysphagia, reflux symptoms, and hiatal hernia recurrence in patients with and without a fundoplication at the time of laparoscopic paraesophageal hernia repair. Patients undergoing laparoscopic PEH repair from July 2006 to June 2012 were identified. Open repairs and reoperative cases were excluded. Patient characteristics, operative details, complications, and postoperative outcomes were recorded. Over the six-year period, 152 laparoscopic PEH repairs were performed. Mean age was 65.8 years (range, 31 to 92) and average body mass index was 29.9 kg/m2 (range, 18 to 52 kg/m2). Concomitant fundoplication was performed in 130 patients (86%), which was determined based on preoperative symptoms and esophageal motility. Mean operative times were similar with fundoplication (188 minutes) and without (184.5 minutes). At a mean follow-up of 13.9 months, there were 19 recurrences: 12.3 per cent (16 of 130) in the fundoplication group and 13.6 per cent (three of 22) in those without. Dysphagia lasting greater than six weeks was present in eight patients in the fundoplication group (6.2%) and in none in those without ( P = 0.603). Eighteen percent of patients without a fundoplication reported postoperative reflux compared with 5.4 per cent of patients with a fundoplication ( P = 0.055). In the laparoscopic repair of PEH, the addition of a fundoplication minimizes postoperative reflux symptoms without additional operative time. Neither dysphagia nor hiatal hernia recurrence is affected by the presence of a fundoplication.

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Wykypiel, H., H. Bonatti, R. A. Hinder, K. Glaser, and G. J. Wetscher. "The laparoscopic fundoplications: Nissen and partial posterior (Toupet) fundoplication." European Surgery 38, no. 4 (August 2006): 244–49. http://dx.doi.org/10.1007/s10353-006-0259-3.

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41

Tapper, Donovan, Connor Morton, Emily Kraemer, Desiree Villadolid, Sharona B. Ross, Sarah M. Cowgill, and Alexander S. Rosemurgy. "Does Concomitant Anterior Fundoplication Promote Dysphagia after Laparoscopic Heller Myotomy?" American Surgeon 74, no. 7 (July 2008): 626–34. http://dx.doi.org/10.1177/000313480807400710.

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Concerns for gastroesophageal reflux after laparoscopic Heller myotomy for achalasia justify considerations of concomitant anterior fundoplication. This study was undertaken to determine if concomitant anterior fundoplication reduces symptoms of reflux after myotomy without promoting dysphagia. From 1992 to 2004, 182 patients underwent laparoscopic Heller myotomy without fundoplication. After a prospective randomized trial justified its concomitant application, anterior fundoplication was undertaken with laparoscopic Heller myotomy in 171 patients from 2004 to 2007. All patients have been prospectively followed. Pre and postoperatively, patients scored the frequency and severity of symptoms of achalasia (including dysphagia, choking, vomiting, regurgitation, chest pain, and heartburn) using a Likert Scale (0 = never/not bothersome to 10 = always/very bothersome). Before myotomy, symptoms of achalasia were frequent and severe for all patients. After myotomy, the frequency and severity of all symptoms of achalasia significantly decreased for all patients ( P < 0.001, Wilcoxon matched pairs test). Notably, relative to patients undergoing laparoscopic Heller myotomy alone, concomitant anterior fundoplication led to significantly less frequent and severe heartburn after myotomy ( P < 0.05, Mann-Whitney Test) and to less frequent and severe dysphagia and choking ( P < 0.05, Mann-Whitney Test). Laparoscopic Heller myotomy reduces the frequency and severity of symptoms of achalasia. Concomitant anterior fundoplication decreases the frequency and severity of heartburn and dysphagia after laparoscopic Heller myotomy. Concomitant anterior fundoplication promotes salutary relief in the frequency and severity of symptoms after myotomy and is warranted.

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Bell, Reginald. "618 Laparoscopic Revision Fundoplication of Transoral Fundoplication." Gastroenterology 146, no. 5 (May 2014): S—1022. http://dx.doi.org/10.1016/s0016-5085(14)63724-0.

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43

Koivusalo, A. I., and M. P. Pakarinen. "Outcome of Surgery for Pediatric Gastroesophageal Reflux: Clinical and Endoscopic Follow-up after 300 Fundoplications in 279 Consecutive Patients." Scandinavian Journal of Surgery 107, no. 1 (April 7, 2017): 68–75. http://dx.doi.org/10.1177/1457496917698641.

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Purpose: Clinical and endoscopic assessment of the outcome after fundoplication for pediatric gastroesophageal reflux. Basic procedures: Hospital records of 279 consecutive patients who underwent fundoplication for gastroesophageal reflux from 1991 to 2014 were reviewed. Underlying disorders, clinical and endoscopic findings, imaging studies, pH monitoring, and surgical technique were assessed. Main outcome measures were patency of fundoplication, control of symptoms and esophagitis, complications, redo operations, and predictive factors of failures. Main results: A total of 279 patients underwent 300 fundoplications (277 primaries and 23 redos). Underlying disorders in 217 (72%) patients included neurological impairment (28%) and esophageal atresia (22%). Indications for fundoplication included recalcitrant gastroesophageal reflux symptoms (44%), failure to thrive (22%), respiratory symptoms (15%), esophageal anastomotic stricture (4%), apneic spells (2%), and regurgitation (2%). Preoperative endoscopy was performed in 92% and pH monitoring in 49% of patients. Median age at primary fundoplication was 2.2 ((IQR = 0.5–7.5)) years. Fundoplication was open in 205 (74%; Nissen n = 63, Boix-Ochoa n = 97, Toupet n = 39, and other n = 6), laparoscopic in 72 (24%; Nissen n = 67 and Toupet n = 5), and included hiatoplasty in 73%. Clinical follow-up was a median of 3.9 (IQR = 1.2–9.9) years. Mortality related to surgery was 0.3%. Symptom control was achieved in 87% of patients, and esophagitis rate decreased from 65% to 29% (p < 0.001). Fundoplication failed in 41 (15%) patients. Failure was predicted by esophageal atresia risk ratio = 3.9 (95% confidence interval = 1.3–11, p = 0.01), any underlying disorder risk ratio = 3.1 (95% confidence interval = 1.1–9.1, p = 0.04), and hiatoplasty risk ratio = 2.6 (95% confidence interval = 1.1–6.6, p = 0.03). Of the 23 redo-fundoplications, 32% failed. Conclusion: The majority of patients who underwent fundoplication had an underlying disorder. Primary fundoplication provided control of symptoms in almost 90% of patients and also reduced the rate of esophagitis. Failure of primary fundoplication occurred in 15% of patients, and an underlying disorder, esophageal atresia, and hiatoplasty increased the risk of failure.

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Rakita, Steven, Desiree Villadolid, Ashley Thomas, Mark Bloomston, Michael Albrink, Steven Goldin, and Alexander Rosemurgy. "Laparoscopic Nissen fundoplication offers High Patient Satisfaction with Relief of Extraesophageal Symptoms of Gastroesophageal Reflux Disease." American Surgeon 72, no. 3 (March 2006): 207–12. http://dx.doi.org/10.1177/000313480607200302.

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Nissen fundoplication is applied for patients with gastroesophageal reflux disease (GERD), usually because of symptoms of esophageal injury. When presenting symptoms are extraesophageal, there is less enthusiasm for operative control of reflux because of concerns of etiology and efficacy. This study was undertaken to evaluate the efficacy of laparoscopic Nissen fundoplication in palliating extraesophageal symptoms of GERD. Patients were asked to score their symptoms before and after laparoscopic Nissen fundoplication on a Likert scale (0 = never/none to 5 = always/every time I eat). A total of 322 patients with extraesophageal symptoms (asthma, cough, gas/bloat, chest pain, and odynophagia) of 4 to 5 were identified and analyzed. After fundoplication, all extraesophageal symptom scores improved (P < 0.0001 for all, Wilcoxon matched-pairs test). Likewise, postoperative symptoms were noted to be greatly improved or resolved in 67 per cent to 82 per cent of patients for each symptom. Furthermore, after fundoplication, patients were less likely to modify their dietary (82% vs 49%) or sleeping habits (70% vs 28%) to avoid initiating/exacerbating symptoms. Although extraesophageal symptoms are conventionally thought to be inadequately palliated by surgery, this study documents excellent relief of extraesophageal symptoms after laparoscopic Nissen fundoplication, denotes high patient satisfaction, and encourages application of laparoscopic Nissen fundoplication.

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Rosemurgy, Alexander, Darrell Downs, Kenneth Luberice, Christian Rodriguez, Forat Swaid, Krishen Patel, Paul Toomey, and Sharona Ross. "Laparoscopic Heller Myotomy with Anterior Fundoplication Improves Frequency and Severity of Symptoms of Achalasia, Regardless of Preoperative Severity Determined by Esophagography." American Surgeon 84, no. 2 (February 2018): 165–73. http://dx.doi.org/10.1177/000313481808400220.

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This study was undertaken to determine whether postoperative outcomes after laparoscopic Heller myotomy with anterior fundoplication could be predicted by preoperative findings on esophagography. Preoperative barium esophagograms of 135 patients undergoing laparoscopic Heller myotomy with anterior fundoplication were reviewed. The number of esophageal curves, esophageal width, and angulation of the gastroesophageal junction (GEJ) were determined; correlations between these determined parameters and symptoms were assessed using linear regression analysis. The number of esophageal curves correlated with the preoperative frequency of dysphagia, vomiting, chest pain, regurgitation, and heartburn. The width of the esophagus negatively correlated with the preoperative frequency of regurgitation. The angulation of the GEJ did not correlate with preoperative symptoms. Laparoscopic Heller myotomy with anterior fundoplication significantly reduced the frequency and severity of all symptoms, regardless of the number of esophageal curves, esophageal width, or angulation of the GEJ. Laparoscopic Heller myotomy with anterior fundoplication provides dramatic palliation for achalasia. More esophageal curves on preoperative esophagography correlate well with the frequency of a broad range of preoperative symptoms, including the frequency of dysphagia and regurgitation. Patients experience dramatically improved frequency and severity of symptoms after laparoscopic Heller myotomy with anterior fundoplication for achalasia regardless of the number of esophageal curves, esophageal width, or the angulation of the GEJ. Findings on barium esophagogram, in evaluating achalasia, should not deter the application of laparosocopic Heller myotomy with anterior fundoplication.

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Arajmand, Shah Touseef, Yaqoob Hassan, Mela Ram Attri, and Nida Shafiq. "Laparoscopic Nissen fundoplication in the management of gastroesophageal reflux disease: a single centre experience." International Surgery Journal 6, no. 5 (April 29, 2019): 1678. http://dx.doi.org/10.18203/2349-2902.isj20191890.

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Background: Laparoscopic Nissen fundoplication is currently the surgical treatment of choice for gastro-esophageal reflux disease (GERD) in properly selected patients.Methods: Laparoscopic Nissen fundoplication was performed in 36 patients of GERD, Government Medical College over a period of 2 years. Pre-operative evaluation included baseline investigations and clinical assessment by using GERD Questionnaire and specific investigations i.e., barium esophagram, esophago-gastroduodenoscopy, esophageal manometry and 24 hour ambulatory pH monitoring of the esophagus. All patients underwent laparoscopic Nissen Fundoplication. Patients were evaluated at three months after surgery with symptom scoring questionnaire.Results: Mean age of patients in our study was 38 years and most common symptoms were heartburn and regurgitation. Four patients (11%) developed complications. The conversion rate to laparotomy was 2.7% (1 patient). Average symptom scores decreased from 10/18 to 0/18 after fundoplication (<0.0001) and all the eight patients who underwent postoperative endoscopy had normal results.Conclusions: Laparoscopic Nissen’s fundoplication is a safe and effective procedure for GERD, having an acceptable hospital stay with consistently improved short term symptomatic and endoscopic results.

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Lukanin, D., G. Rodoman, M. Klimenko, A. Sokolov, and A. Sokolov. "Quality of life after anti-reflux surgical interventions: possible solutions to the problem." Hirurg (Surgeon), no. 1-2 (February 1, 2020): 3–25. http://dx.doi.org/10.33920/med-15-2001-01.

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The article presents the results of a prospective controlled parallel clinical study of a new modification of laparoscopic antireflux surgery in the treatment of gastroesophageal reflux disease in combination with a hiatal hernia compared with laparoscopic Nissen fundoplication in terms of assessing quality of life after surgery. Clinical and instrumental examination of patients was carried out a year after surgical interventions. In accordance with the results of instrumental examination after surgery, the proposed modification of laparoscopic partial fundoplication is not inferior to laparoscopic Nissen fundoplication both, in terms of relief of reflux esophagitis symptoms and in relation to the recurrence of hiatal hernia. Clinical monitoring indicates a significantly higher quality of life for patients after the modified antireflux surgery, which is associated with a number of factors. The implementation of this fundoplication led to a decrease in the number of patients with complaints of dysphagia, the development of which is directly related to the surgery performance, as well as to a statistically significant reduction of bloating in the upper abdomen. Another advantage of the modified surgery is a significantly smaller number of cases of gas-bloat syndrome. In addition, the disorders developing in the framework of the gas bloat syndrome after laparoscopic Nissen fundoplication are more severe.

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Joris, Jean L., Jean-Daniel Chiche, and Maurice L. Lamy. "Pneumothorax During Laparoscopic Fundoplication." Anesthesia & Analgesia 81, no. 5 (November 1995): 993–1000. http://dx.doi.org/10.1097/00000539-199511000-00017.

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Schietroma, Mario, Fabiola De Vita, Francesco Carlei, Sergio Leardi, Beatrice Pessia, Federico Sista, and Gianfranco Amicucci. "Laparoscopic Floppy Nissen Fundoplication." Surgical Laparoscopy, Endoscopy & Percutaneous Techniques 23, no. 3 (June 2013): 281–85. http://dx.doi.org/10.1097/sle.0b013e31828e3954.

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FRANTZIDES, CONSTANTINE T., and MARK A. CARLSON. "Laparoscopic Redo Nissen Fundoplication." Journal of Laparoendoscopic & Advanced Surgical Techniques 7, no. 4 (August 1997): 235–39. http://dx.doi.org/10.1089/lap.1997.7.235.

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