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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.
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.
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.
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]
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 ...
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.
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.