Laparoscopic Fundoplication: A Preliminary Report of the Technique and Postoperative Care

Falk, Gregory L.; Brancatisano, R.; Hollinshead, John; Moulton, John

doi:10.1111/j.1445-2197.1992.tb07656.x

Cited by 16 publications

(3 citation statements)

References 3 publications

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“…Since the initial description by Dallemagne et al in 1991 [5], a number of reports have appeared in the surgical literature. With a few exceptions [3,12,23], descriptions are generally of small numbers [1,2,8,10,11,14,18,22] and provide only minimal follow-up. Because of the recent description of this technique, it will take several years before longterm outcomes in large patient groups can be evaluated.…”

Section: Discussionmentioning

confidence: 99%

Changing strategies in the performance of laparoscopic Nissen fundoplication as a result of experience with 230 operations

et al. 1995

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From September 1991 to January 1995 we performed 230 Nissen fundoplications by a laparoscopic technique. Whilst a loose 360 degree fundoplication secured by 3 or 4 sutures was performed in all instances, there was variation between surgeons regarding the performance of hiatal repair and division of short gastric vessels; 207 operations were completed laparoscopically and 23 were converted to an open operation when a satisfactory wrap could not be achieved. Operating time ranged from 30 to 260 min (median 95) and the median postoperative stay was 3 days (1-19). Twenty-three patients (10%) underwent a subsequent operation (14 within 3 months of the original surgery), 2 for recurrent reflux, 10 for para-esophageal herniation, 2 for a misplaced fundoplication resulting in gastric obstruction, 7 for persistent dysphagia (4 due to stenosis of the esophageal hiatus), 1 for bleeding, and 1 for mesenteric thrombosis. (This patient died.) Five other patients were readmitted to hospital subsequent to their discharge--four because of pulmonary emboli and one because of gastric obstruction. Some 226 patients (98%) are free of reflux symptoms with follow-up ranging up to 40 months (median 16). Absence of reflux and the integrity of the fundoplication has been confirmed by postoperative esophageal manometry and pH monitoring in 90 patients, and by barium meal in 126. Postoperative recovery has been quick and wound-related morbidity minimal. Although the rate of surgical revision was significant in this series, the likelihood of complications or further surgery, as well as incidence of conversion to open surgery, decreased in the second half of the experience.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 99%

Changing strategies in the performance of laparoscopic Nissen fundoplication as a result of experience with 230 operations

et al. 1995

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“…Dallemagne et al [16] demonstrated the feasibility of this in their initial series of 12 patients. Geagea [17] and Falk et al [18] all reported good initial results in preliminary series of 10 and 16 patients, respectively. Five patients of our study group presented with a documented hiatus hernia on endoscopy and CT scan.…”

Section: Discussionmentioning

confidence: 93%

Laparoscopic Fundoplication for Gastro-esophageal Reflux Disease and Hiatus Hernia: A Short Term Outcome of First 8 Cases

Chalkoo

Rather

Mohiuddin

et al. 2019

JAMMR

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Background: Acute gastro-esophageal reflux disease is a common ailment in kashmiri population. Most of these patients are managed by gastroenterologist, physicians and surgeons in daily outpatient basis. Majority of them settle by medical management with the help of proton pump inhibiters, prokinetics and antacids., laparoscopic Nissen's fundoplication (LNF) is currently the procedure of choice for the surgical management of GERD. Aims and Objectives: The aim of this study was to know the feasibility of laparoscopic fundoplication for hiatus hernia and acute gastro-esophageal reflux disease in terms of operative time, post operative pain, length of hospital stay, conversion rate and recurrence of symptoms. . The patients that were included in the study had symptomatic gastro-esophageal reflux (documented by endoscopy) with either persistent Chalkoo et al.; JAMMR, 30(2): 1-10, 2019; Article no.JAMMR.49996 2 symptoms despite adequate and prolonged medical treatment, CT documented hiatus hernia and patients, who wanted to avoid long-term medical treatment. The duration of reflux symptoms ranged from 9 months to 30 years (median 6 years). Patients who were excluded from the study were those unfit for anesthesia. Informed consent was taken before surgery in the language, the patients understood. Results: This study includes 8 patients, with median age of 40 years (range 20-70 years). In the study group, 5 were males and 3 were females. The mean operative time was 90 minutes (range 60 t0 120 minutes). There were no major intra operative and post operative complications. The post operative pain was minimal as compared to open surgery. The median hospital stay was 3.5 days (range 3 -6 days). Two patients developed symptoms of bloating, early satiety, nausea and diarrhea. However these symptoms improved within weeks with a good response to appropriate medication. The median time until normal physical activity resumed was 2 weeks (range 3 days to 4 weeks). Median follow-up was 6 months (range1-12 months). The overall short-term results in appropriately selected patients were excellent. The recurrence of symptoms was not observed in any patient within follow up of 6 months. Conclusion: We conclude from our early series of 8 cases, that patients having long standing GERD not responding to medical management who are at a threat to develop barrettes esophagus should be given the benefit of laparoscopic fundoplication. However proper evaluation, patient selection is mandatory. The choice of fundoplication should be dictated by the surgeon's preference and experience. Currently, the main indication for laparoscopic fundoplication is represented by PPI-refractory GERD, provided that objective evidence of reflux as the cause of ongoing symptoms has been obtained by impedance-pH monitoring. Original Research Article

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“…In the early 1990s, reports began to appear describing the techniques and results of laparoscopic fundoplication for reflux esophagitis [41][42][43][44][45][46][47]. Early results were excellent, with low complication rates and almost immediate relief of gastroesophageal symptoms.…”

Section: Laparoscopic Hiatal Hernia Fundoplication For Esophagitismentioning

confidence: 99%

Minimally invasive (laparoscopic) surgery

Himal

2002

Surgical Endoscopy

103

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Minimally invasive (laparoscopic) surgery became a major part of general surgery with the introduction of laparoscopic cholecystectomy in the late 1980s. This was the culmination of the development of instruments and techniques by many physicians; Kelling developing pneumoperitoneum, Zollikofer using carbon dioxide, Kalk designing a lens system and the dual-trochar technique, Veress using the Veress needle to create pneumoperitoneum, Hasson developing the Hasson trochar, Semm carrying out the first laparoscopic appendectomy, and Muhe and Perrisat carrying out and popularizing laparoscopic cholecystectomy. At the present time, minimal invasive surgery has become the most important part of general surgery.

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Laparoscopic Fundoplication: A Preliminary Report of the Technique and Postoperative Care

Abstract: The technique of laparoscopic fundoplication and its hospital management are described. Thirty day results in seven patients demonstrate the decreased insult to the patient, early discharge and early return to usual function, similar to that seen in laparoscopic cholecystectomy .

Cited by 16 publications

References 3 publications

Changing strategies in the performance of laparoscopic Nissen fundoplication as a result of experience with 230 operations

Changing strategies in the performance of laparoscopic Nissen fundoplication as a result of experience with 230 operations

Laparoscopic Fundoplication for Gastro-esophageal Reflux Disease and Hiatus Hernia: A Short Term Outcome of First 8 Cases

Minimally invasive (laparoscopic) surgery

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