Gastro-oesophageal Reflux
Nissen Fundoplication
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Introduction
A Nissen Fundoplication is performed in cases where the patient is suffering from gastro-oesophageal reflux.
To treat severe cases of gastro-esophageal reflux disease (GERD), it is sometimes necessary to perform a Nissen Fundoplication procedure, which consists of wrapping the gastric fundus around the esophagus. The video endoscopic approach, by dramatically reducing parietal trauma, allows for less pain in the post-operative period and for a shortened hospital stay.
The operation is quite benign, since no resection or opening of the digestive lumen occurs. The difficulty and the aggressiveness of the procedure lie in the difficulty of access, since the anatomical location of the hiatal region necessitates important trauma to the abdominal wall in order to gain access. This trauma to the abdominal wall will determine the morbidity of the procedure, the length of the hospitalization and the working incapacity for the patient. The approach of the hiatus with the help of sharp and long instruments puts the patient at risk of undergoing traumatic perforation of the esophagus and therefore a well defined and codified dissection technique has to be described.