NISSEN FUNDOPLICATION BY VIDEOLAPAROSCOPY

One hundred and sixty two laparoscopic fundoplications were performed between may 1991 and december 1993 by the first author. No perioperati ve death was observed. There were 4 intraoperative complications (3 %) : 1 gastric perforation, 2 pleural perforations and 1 liver laceration . There were 3 conversions to laparotomy: 2 for left liver hypertrophy and 1 for needle holder defect. The duration of the operation ranged from 40 minutes to 5 hours (median 120 minutes). The median postoperat ive stay was 2 days. Five postoperative complications occurred : 2 cas es of pneumonia and 3 cases necessitating second-look laparatomy (1 ne crosis of the valve, 1 small bowel perforation and 1 obstruction due t o migration of the entire stomach into the chest), The follow-up range s from 4 to 897 days (median 10 months). Long-term complications were: one recurrence of heartburn reoperated laparoscopically and two cases of long-term postoperative dysphagia.