Laparoscopic Nissen fundoplication: preliminary report.

TLDR

Twelve patients with symptomatic esophagitis and hiatal hernia underwent laparoscopic Nissen fundoplication, with nine procedures completed laparoscopically, and postoperative assessment included endoscopy, manometry, and barium studies. Postoperative evaluation showed excellent results with no mortality, one pneumonia complication, and six of twelve patients asymptomatic at one month, supporting the feasibility of laparoscopic Nissen fundoplication for GERD with hiatal hernia.

Abstract

Twelve patients presenting with symptomatic esophagitis associated with hiatal hernia and gastroesophageal reflux underwent operative management under laparoscopic guidance. The antireflux procedure employed was the Nissen fundoplication. The authors completed the operation laparoscopically in nine patients. Postoperatively, patients were evaluated with repeat fiberoptic endoscopy, esophageal manometry, and barium contrast studies. Postoperative results were considered excellent on the basis of these studies and complete control of symptoms. The mortality rate was 0%. The only major operative complication was a pneumonia that occurred in one patient. At 1 month follow-up, six patients were totally asymptomatic. The authors conclude that laparoscopic treatment of gastroesophageal reflux associated with a hiatal hernia is feasible by a procedure that has already proven its value during open surgery.