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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.
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 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 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 Collis gastroplasty is a surgical procedure performed when the surgeon desires to create a Nissen fundoplication, but the portion of esophagus inferior to the diaphragm is too short. Thus, there is not enough esophagus to wrap. A vertical incision is made in the stomach parallel to the left border of the esophagus.
Transoral incisionless fundoplication (TIF) is an endoscope treatment designed to relieve symptoms of gastroesophageal reflux disease (GERD). The TIF procedure, similar to Nissen fundoplication , alleviates GERD symptoms by wrapping a portion of the stomach around the esophagus.
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 ...
Laparoscopy (from Ancient Greek λαπάρα (lapára) 'flank, side' and σκοπέω (skopéō) 'to see') is an operation performed in the abdomen or pelvis using small incisions (usually 0.5–1.5 cm) with the aid of a camera.