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A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via laparoscopic surgery, is a surgical procedure to treat gastroesophageal reflux disease (GERD) and hiatal hernia. In GERD, it is usually performed when medical therapy has failed; but, with a Type II (paraesophageal) hiatus hernia, it is the first-line procedure.
The Nissen fundoplication procedure consists of a 360 degree transabdominal fundoplication. A fundoplication is the suturing of the fundus located in the stomach and around the esophagus. [5] The procedure itself is performed with the patient in a low lithotomy position at approximately 25 degrees.
Truncal vagotomy is a treatment option for chronic duodenal ulcers. [5] [6] It was once considered the gold standard, but is now usually reserved for patients who have failed the first-line "triple therapy" against Helicobacter pylori infection: two antibiotics (clarithromycin and amoxicillin or metronidazole) and a proton pump inhibitor (e.g., omeprazole).
Hiatal hernia has often been called the "great mimic" because its symptoms can resemble many disorders. Among them, a person with a hiatal hernia can experience dull pains in the chest, shortness of breath (caused by the hernia's effect on the diaphragm), heart palpitations (due to irritation of the vagus nerve), and swallowed food "balling up ...
General surgery. Signature. Rudolph Nissen (sometimes spelled Rudolf Nissen) (September 5, 1896 – January 22, 1981) was a German surgeon who chaired surgery departments in Turkey, the United States and Switzerland. The Nissen fundoplication, a surgical procedure for the treatment of gastroesophageal reflux disease, is named after him.
One of the most common symptoms of a vagus nerve injury is chronic cough. If a physician looked into the vocal cords of a patient with chronic cough it would appear they are opening and closing normally, however if sensory testing was performed it would give abnormal results thus indicating that the sensory nerve fibers of the vagus were ...
Anatomical terms of neuroanatomy. [edit on Wikidata] The anterior vagal trunk is one of the two divisions (the other being the posterior vagal trunk) into which the vagus nerve splits as it passes through the esophageal hiatus to enter the abdominal cavity. [1] The anterior and posterior vagal trunks represent the inferior continuation of the ...
The standard surgical treatment for severe GERD is the Nissen fundoplication. In this procedure, the upper part of the stomach is wrapped around the lower esophageal sphincter to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia. [61] It is recommended only for those who do not improve with PPIs. [42]