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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.
"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".
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]
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 ...
Pyloromyotomy is a surgical procedure in which a portion of the muscle fibers of the pyloric muscle are cut. This is typically done in cases where the contents from the stomach are inappropriately stopped by the pyloric muscle, causing the stomach contents to build up in the stomach and unable to be appropriately digested.