The Nissen fundoplication: indication, technical aspects and postoperative outcome

Abstract

The laparoscopic Nissen fundoplication is the most commonly used operation technique. It provides good long-term results in the majority of patients. However, due to an increase of outflow resistance of the oesophagus this operation is associated with some postoperative side effects. Therefore, alternative anti-reflux procedures may be indicated in selected patients.

Laparoscopic partial posterior (Toupet) fundoplication improves esophageal bolus propagation on scintigraphy

“…Although laparoscopic Nissen fundoplication has a very wide acceptance and can be considered as the standard procedure in antireflux surgery, there have been some concerns in recent publications about an overcorrection of the LES with a rate of long-term dysphagia of up to 30% [21][22][23]. Therefore, a tailored approach has been emphasized in order to reduce the rate of side-effects [13], taking into account a possible higher recurrence rate of GERD after partial posterior fundoplication [24][25][26].…”

Roboterassistierte laparoskopische Cardiomyotomie

“…The robot instruments, usually an electrocautery hook and a grasper (Cadière, Intuitive Surgical, Mountain view, CA), and the camera providing the three-dimensional image were inserted through the ports and plugged to the robot arms. Subsequently, the operation exactly followed our technique for conventional laparoscopic cardiomyotomy with partial posterior fundoplication [30,31]. The liver was retracted and using the Babcock forceps the gastric fundus was pulled to the left.…”

Robotic suturing: Technique and benefit in advanced laparoscopic surgery

“…For obesity surgery, fundoplication and adrenalectomy the technique is promoted as standard of care (1)(2)(3)(4). In recent years, laparoscopy has expanded from simple ablative procedures to more advanced reconstructive surgery requiring suturing and knot-tying in a narrow working space or at angles unergonomic for conventional laparoscopy (5).…”