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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 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]
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.
Named after the Major League Baseball pitcher who was the first professional athlete to undergo the procedure, in 1974. [8] Toupet fundoplication: Andre Toupet: Upper gastrointestinal surgery: Fundoplication with 270° posterior wrap: Laparoscopy Hospital article: Trendelenburg's operation [9] Friedrich Trendelenburg: Cardiothoracic surgery
After surgery, patients should keep to a soft diet for several weeks to a month, avoiding foods that can aggravate reflux. [35] The most recommended fundoplication to complement Heller myotomy is Dor fundoplication, which consists of a 180- to 200-degree anterior wrap around the esophagus. It provides excellent results as compared to Nissen's ...
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.
Nausea and vomiting can be extremely distressing for patients, and so is one of their major concerns. [10] Vomiting has been associated with major complications, such as pulmonary aspiration of gastric content, and might endanger surgical outcomes after certain procedures, for example after maxillofacial surgery with wired jaws.
"During a laparoscopic Nissen fundoplication the operable area is inflated with gas to make the operation easier, which puts pressure on gastrointestinal organs, inhibiting their correct function. This, in conjunction with psychological and physical trauma from the operation, results in "post operative irritable bowel syndrome".