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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 stomach fundus can then be wrapped around the neo-esophagus, thus reducing reflux of stomach acid into the esophagus. In fact, gastroplasty can be used when the length of the intra-abdominal esophagus is short and for anti-reflux action such as Nissen fundoplication, it is necessary to increase the intra-abdominal length of the esophagus.
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.
Acid reflux into the mouth can cause breakdown of the enamel, especially on the inside surface of the teeth. A dry mouth, acid or burning sensation in the mouth, bad breath and redness of the palate may occur. [27] Less common symptoms of GERD include difficulty in swallowing, water brash, chronic cough, hoarse voice, nausea and vomiting. [26]
A hiatal hernia or hiatus hernia [2] is a type of hernia in which abdominal organs (typically the stomach) slip through the diaphragm into the middle compartment of the chest. [1] [3] This may result in gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) with symptoms such as a taste of acid in the back of the mouth or heartburn.
It provides excellent results as compared to Nissen's fundoplication, which is associated with higher incidence of postoperative dysphagia. [34] The shortcoming of laparoscopic esophageal myotomy is the need for a fundoplication. On the one hand, the myotomy opens the esophagus, while on the other hand, the fundoplication causes an obstruction.
Nissen fundoplication: Rudolph Nissen: Upper gastrointestinal surgery, laparoscopic surgery: Gastric fundus is wrapped fully around the lower oesophagus to treat gastroesophageal reflux disease: Nissen's fundoplication at Who Named It? Paul's operation: Frank Thomas Paul (1851–1941) Colorectal surgery: Extra-abdominal resection of colon [6 ...
Laryngopharyngeal reflux (LPR) or laryngopharyngeal reflux disease (LPRD) is the retrograde flow of gastric contents into the larynx, oropharynx and/or the nasopharynx. [4] [5] LPR causes respiratory symptoms such as cough and wheezing [6] and is often associated with head and neck complaints such as dysphonia, globus pharyngis, and dysphagia. [7]