LAPAROSCOPIC NISSEN-ROSSETTI FUNDOPLICATION - FIRST RESULTS

From January 1992 to July 1994, 148 patients with symptomatic gastroes ophageal reflux and/ or hiatal hernia underwent Nissen-Rossetti fundop lication by a laparoscopic approach. There was no conversion and no po stoperative death. The main intraoperative complications were hemorrha ge (n = 12), pleural opening (n = 5), and gastric perforation (seromus cular effraction) (n = I). Laparoscopic reoperation was necessary in t wo patients as a result of bleeding, and there were two cases of food impaction. The median hospital stay was 4.9 days; 117 patients were ob served for follow-up for 3-31 months (median 6.2 months). Eleven cases of dysphagia extending beyond 2 months have been observed. In five of those cases, endoscopic dilatation provided effective treatment of dy sphagia and in four others, a further laparoscopic intervention enable d a cure to be obtained. Eighty-four percent are satisfied with their decision to have the operation. The laparoscopic Nissen-Rossetti fundo plication can be carried out safely and effectively with positive resu lts similar to those obtained with the open procedure and with all of the advantages of the minimally invasive approach.