LAPAROSCOPIC NISSEN FUNDOPLICATION

Objective The authors' laparoscopic approach for a Nissen fundoplicati on is presented. Summary Background Data The technique has been undert aken in 155 patients over 29 months, with 137 patients having been obs erved for more than 3 months. Results The operation was not completed laparoscopically in 19 patients because a satisfactory wrap could not be achieved. Ten patients undergoing laparoscopic fundoplication under went a subsequent operation related to the laparoscopic procedure with in 6 months, and there was one postoperative death. Seven other patien ts were readmitted to the hospital several days subsequent to their di scharge, four because of pulmonary emboli. Of 137 patients who have be en observed for more than 3 months, 133 patients are well and currentl y are free from reflux symptoms. Conclusions In uncomplicated cases, l aparoscopic fundoplication has similar advantages to laparoscopic chol ecystectomy. In spite of the fact that it has not yet achieved the ove rall usefulness of open fundoplication, it seems likely that laparosco pic fundoplication will be used increasingly in the treatment of patie nts with gastroesophageal reflux disease.