LAPAROSCOPIC ROSETTI FUNDOPLICATION

Early experiences with laparoscopic fundoplication using the Rosetti t echnique are presented and compared with retrospective results from co nventional fundoplication procedures. A 360-degrees floppy fundoplicat ion was laparoscopically constructed without division of short gastric vessels. We have performed 60 consecutive procedures. Conversion to o pen surgery was done in seven cases due to anatomical reasons and in t wo due to progressive subcutaneous emphysema and CO2-retention. The co mplication rate was low. The range of postoperative hospital stay is 1 -4 days for non-converted patients. Symptomatic follow up has hitherto been performed in 41 patients with a follow-up time of 3-9 months. Re gurgitation and heartburn had disappeared in all but one patient. The follow-up results do not differ from those achieved in patients operat ed upon with the conventional open Nissen (N = 41), Toupet (N = 9) or Rosetti (N = 36) technique. Pre and postoperative control of 24h pH an d lower esophageal sphincter pressure (LESP) in 19 laparoscopically tr eated patients showed normalisation of LESP in all cases and postopera tive 24h pH < 4 ranging between 0 and 3%. Assessment of quality of lif e showed postoperative results in accordance with normal population fo r all treated groups.