LAPAROSCOPIC NISSEN FUNDOPLICATION - TECHNIQUE AND PRELIMINARY-RESULTS

Between May 1991 and November 1992, 80 consecutive patients with gastr o-oesophageal reflux disease underwent laparoscopic Nissen fundoplicat ion. The technique used was exactly the same as for the conventional o pen approach. There were no deaths but there were four peroperative co mplications: one gastric perforation, two pleural perforations and one hepatic laceration. Three conversions to laparotomy were necessary, o ne because of a defective needle holder and two as a result of left he patic lobe hypertrophy. The duration of operation ranged from 40 to 30 0 (median 150) min. The median postoperative stay was 3 days, but incr eased to 10 days in two patients who developed pulmonary infection. On e major postoperative complication (necrosis of the wrap) required a l aparotomy on day 8 after operation. No recurrence of heartburn has bee n observed and there were no instances of long-term dysphagia after su rgery. These findings indicate that laparoscopic Nissen fundoplication can be performed safely if the team is well trained.