Affordable Access

Laparoscopic Nissen fundoplication: The "right posterior" approach

Authors
Journal
Journal of Gastrointestinal Surgery
1091-255X
Publisher
Springer-Verlag
Publication Date
Keywords
  • Gastroesophageal-Reflux
  • Antireflux Surgery
Disciplines
  • Biology
  • Mathematics
  • Medicine

Abstract

The main steps for performing a laparoscopic Nissen fundoplication are described: They start with a "right approach" by dissection of the high lesser curve, near the esophagogastric junction. Then the posterior surface of the stomach is easily visualized by the "posterior approach." The fat pad and both vagal trunks are displaced to the right, avoiding any vagal injury. Two to three short gastric vessels are divided, leaving a loose gastric fundus. A 360 total symmetric and geometric fundoplication is then performed, including the esophageal wall in the most proximal and distal stitch. A final stitch for an anterior fundophrenopexy is performed. This surgical approach has been used in 225 patients with severe chronic pathologic reflux with a 1.3% conversion rate, no mortality, and only one significant postoperative complication. Late evaluation at 5 years after surgery has shown excellent or good results in 85% and fair or poor results in 15% of the patients.

There are no comments yet on this publication. Be the first to share your thoughts.

Statistics

Seen <100 times
0 Comments

More articles like this

Laparoscopic Nissen Fundoplication: The “Right Pos...

on Journal of Gastrointestinal Su... Jan 01, 2005

Laparoscopic Nissen fundoplication: the "right pos...

on Journal of Gastrointestinal Su... 2005

Left side first: a different approach for teaching...

on Journal of the American Colleg... April 2001
More articles like this..