EFFICACY OF ANTERIOR, POSTERIOR AND TOTAL FUNDOPLICATION IN AN EXPERIMENTAL-MODEL

Background This study examined the effect of different types of laparo scopic fundoplication on an incompetent lower oesophageal sphincter to test their effectiveness at preventing gastrooesophageal reflux in th e early postoperative period. Methods An experimental porcine model wa s used. Initial oesophageal myotomy ensured an incompetent lower oesop hageal sphincter with free reflux of 'intragastric fluid'. Anterior, p osterior or total fundoplication was then performed laparoscopically i n 15 laboratory pigs (five in each group). Fundoplication competence a nd efficacy were determined 2 weeks after laparoscopic antireflux surg ery by inflating the stomach with liquid through a gastrostomy cannula . Some animals were also studied at 4 and 6 weeks. Lower oesophageal s phincter pressure was determined using a water-perfused oesophageal ma nometry catheter incorporating a Dent sleeve. Results All three types of fundoplication produced similar increases in postoperative resting lower oesophageal sphincter pressure and restored adequate competence to the gastro-oesophageal junction. Conclusion All three variants of l aparoscopic fundoplication restore gastro-oesophageal competence in th e early postoperative period.