Background: Early experiences with laparoscopic fundoplication using t
he Rosetti technique are presented and compared with retrospective res
ults from conventional fundoplication procedures. Methods and results:
We have performed 70 consecutive laparoscopic procedures. Conversion
to open surgery was done in seven cases because of anatomical reasons
and in two because of peroperative progressive subcutaneous emphysema
and CO2-retention. The complication rate was low. The range of postope
rative hospital stay is 1-4 days for non-converted patients. Symptomat
ic follow-up has hitherto been performed in 41 patients with a follow-
up time of 3-9 months. The follow-up results do not differ from those
achieved in patients operated upon with the conventional open Nissen (
n = 41) and Rosetti (n = 36) techniques. Pre- and postoperative contro
l of 24 h pH and lower esophageal sphincter pressure (LESP) in 19 lapa
roscopically treated patients showed normalization of LESP in all case
s and postoperative 24 h pH < 4 ranging between O and 3%. Conclusions:
Laparoscopic and reflux surgery is effective for the treatment of ref
lux esophagitis. Follow-up results compare well with open surgery.