A stepwise approach to laparoscopic Nissen fundoplication - Avoiding technical pitfalls

Laparoscopic Nissen fundoplication is now widely used in the surgical manag ement of gastroesophageal reflux disease. However, it is a complex operatio n that requires advanced laparoscopic skills. The learning curve is steep, and complications are directly related to the surgeon's experience level. B oth experimental and clinical data demonstrate a decline in complications w ith increasing experience. We divided this complex procedure into logical a nd orderly components, to facilitate the learning process. We believe that this approach will not only reduce complications by highlighting potential problems at each stage but also make it easier to teach others.