Nissen fundoplication

When fundoplication is referred to surgery for the treatment of reflux oesophagitis or hiatus hernia.

Technology

The operation can be performed both open surgery and laparoscopy (by laparoscopy ). As part of the engagement portions of the gastric fundus are loosely wrapped around the lower esophageal sphincter and fixed by a suture. The goal is the additional support of the sphincter by the resulting pressure of the cuff at filling of the stomach after ingestion. Thus, the disease-causing reflux of gastric contents into the esophagus is prevented.

Indication

A fundoplication is indicated in patients with reflux esophagitis who did not adequately respond to medical therapy with high-dose proton pump inhibitors and hiatal hernias.

Healing and complications views

About 90 % of the treated cases show a healing of esophageal inflammation. Potential complications include passage problems, dumping syndrome, loosening the cuff with recurrence of reflux. In addition, the suppression of belching can cause the cuff to a feeling of fullness in the left upper abdomen.

History of Medicine

The fundoplication was developed by the German surgeon Rudolf Nissen and established (published 1956). Development for the partial 270 degrees fundoplication ( Hemiplicatio not complete cuff around the abdominal portion of the esophagus) was carried out by the French Andre Toupet (published 1963). Other variants are the laparoscopic ventral Hemiplicatio with 150 ° to 200 ° by Jacques Dor (1962) and Thal ( 1968) with 90 ° (anterior Hemiplicatio ).