Laparoscopic Nissen fundoplication: Technique and preliminary results

Cadière, Guy-Bernard; Houben, Jean-Jacques; Bruyns, Jean Andre; Himpens, Jacques; Panzer, Jean Marc; Gelin, Michel

doi:10.1002/bjs.1800810327

Cited by 122 publications

(40 citation statements)

References 9 publications

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“…Subsequent early reports all described encouraging short-term outcomes [1,2,4,10,11,18,22,23]. However, the procedure is not without the risk of complications, including some specific to the laparoscopic approach.…”

mentioning

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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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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“…Bei voroperierten Patienten oder bei Auffälligkeiten der verschiedenen Sicherheitstests mit der Veress-Nadel sollte ebenfalls auf einen offenen Zugang zur Laparoskopie gewechselt werden. Die Milzblutungen, die zu Zeiten der offenen Antirefluxchirurgie eine gewisse Rolle spielten, sind im Zeitalter der laparoskopischen Operationstechnik auf ein Minimum reduziert worden [8,[10][11][12] …”

Section: Intraoperative Problemeunclassified

“…die Frage nach der Notwendigkeit der Fundusmobilisierung, da diese initial laparoskopisch-technisch recht aufwendig war und Gefahren barg [13][14][15]. Wie Tabelle 1 zeigt, konnten die Ergebnisse der laparoskopischen Operationstechnik bei der Nissen-Fundoplicatio an die Resultate aus der Zeit der konventionellen Antirefluxchirurgie nahtlos anschließen [8,11,12,[16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Besonders durch Bereitstellung entsprechender Instrumente und Apparate ist es heute problemlos möglich, mit gleicher Sicherheit diese Operation wie ihre offene Variante durchzuführen.…”

Section: Operationsergebnisseunclassified

Technik und Langzeitergebnisse der laparoskopischen Fundoplicatio nach Nissen

Freys¹,

Maroske²,

Fein³

et al. 2001

Visc Med

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Technique and Long-Term Results of Laparoscopic Nissen Fundoplication Thirty-five years after the first fundoplication by Nissen, this operative technique was performed laparoscopically for the first time in 1991. The available data on long-term results prove that the standards for security and quality of this operative method were held constant since introduction of the minimally invasive technique. Increasing knowledge on pathophysiology as well as a differentiated patient selection are factors contributing to the fact that Nissen fundoplication currently worldwide represents the standard method of operative treatment in gastroesophageal reflux disease.

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“…In fact, the treatment of GER represents a perfect illustration of the objectives of minimal access surgery since it allows to perform a complex procedure for a functional disorder without damaging the abdominal wall. Since 1994, several series, individual [17][18][19][20][21], multicentric, nonrandomized or randomized [22], have been performed. All the procedures performed in open surgery have been adapted to the laparoscopic approach and the results show that the mortality and morbidity rates [23][24][25] are similar to those obtained in open surgery, perhaps even better.…”

Section: Nonmalignant Disordersmentioning

confidence: 99%

Advances in Laparoscopic Surgery

1998

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After a brief account of the origins of laparoscopy and of its development into an interventional technique thanks to technical improvement, the author gives a dynamic state of the art in laparoscopic surgery, beginning with a description of his original classification method for laparoscopic procedures according to their level of use. Before tackling the highly controversial issue of laparoscopic surgery for cancer, he reviews in detail the various operations successfully performed by laparoscopy for the treatment of nonmalignant abdominal disorders and acute syndromes, all the while checking their results against those obtained with their open counterparts. As the various procedures are described, the interest of the laparoscopic approach becomes clearly visible, based on the excellent view of the operative field that allows diagnostic accuracy, thus avoiding unnecessary operations, and precise dissection with minimal damage. However, the laparoscopic approach is highly dependent on the surgeon’s proficiency, itself depending on experience and therefore on the frequency of occurrence of the disorder, and on the progress in and availability of adequate equipments. The last chapter looks into the future of this ever-expanding approach and defines two great trends in its evolution, one accessible to the individual surgeon, the gradual adaptation of open procedures into laparoscopic ones, the other at the institutional level, in view of the huge financial support involved if high technologies are to be systematically integrated in this new surgery. What will the future be like?

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Laparoscopic Nissen fundoplication: Technique and preliminary results

Cited by 122 publications

References 9 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

Technik und Langzeitergebnisse der laparoskopischen Fundoplicatio nach Nissen

Advances in Laparoscopic Surgery

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